A Pregnant Woman’s Guide to Swine Flu

If I were pregnant now, I would be confused and somewhat scared by the news: Pregnant women infected with H1N1 (swine flu) have a higher rate of hospitalization and greater risk of death than the nonpregnant population.

Six pregnant women in the U.S. died of the virus between April 15 and June 16 (that’s 13% of the 45 deaths reported to the CDC). So why are pregnant women in danger?

“Pregnant women tend to be sicker when they have the flu, partly because of changes in the immune system, partly because the physiological stress of normal pregnancy pushes their heart and lungs to work harder, and partly because their lung blood vessels tend to be a bit ‘leaky’ anyway,” says Charles Lockwood, MD, the chief of obstetrics and gynecology at Yale–New Haven Hospital.

Changing lung anatomy may play a role as well. The flu symptom that pregnant women tend to suffer from disproportionately is “shortness of breath,” according to a report published by the CDC in The Lancet.

Most of the pregnant women who died were healthy before they contracted the flu, so it feels particularly insidious and frightening. Should women postpone pregnancy until this flu season is over? And should pregnant women freak out about catching this virus?

“While I would not postpone pregnancy, I would recommend that pregnant women be vaccinated as soon as a mass-produced, tested, safe, and efficacious vaccine is available,” Dr. Lockwood says.

Such a vaccine is due to be released this fall, with priority access for pregnant women.

I hope to get the vaccine, too, if there are enough to go around. I don’t want to be the one who passed H1N1 on to pregnant women, when it’s potentially lethal for them, and my baby won’t be old enough to receive the vaccine.

In the meantime, though, pregnant women should read the CDC’s guide of recommendations for preventing the H1N1 virus. But there is an upshot: If you are pregnant, and you may have H1N1, your best course of action is to take antiviral medication such as Tamiflu (oseltamivir) or Relenza (zanamivir), which keep germs from growing in the body within the first two days that your symptoms begin.

Treating the flu early seems to be the trick. The six women who died of H1N1 in the CDC’s study did not receive antiviral drugs until between 6 and 15 days from their symptom onset.

Unfortunately for those of us who are paranoid about medications we put into our pregnant bodies, these antiviral drugs are “Category C,” meaning that “clinical studies have not been done to assess the safety of their use during pregnancy,” according to this article on UpToDate.

Although no adverse side effects have been reported in women and their fetuses who have taken the antiviral medication, these drugs are not clinically proven to be safe. However,  if I were pregnant, I would consider popping those pills at the first sign of a fever.

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