This page explains why pregnant women are at greater risk from H1N1 flu, what those risks are, the special precautions you should take and the safety information for H1N1 flu treatments.
Why pregnant women are more at risk
In pregnancy, the immune system is naturally suppressed. This means that pregnant women are more likely to catch flu and, if they do catch it, they are more likely to develop complications (see below).
However, your immune system still functions and the risk of complications is very small. Most pregnant women will only have mild symptoms.
Symptoms and risks
If you are pregnant and you catch H1N1 flu, the symptoms should be similar to those of regular flu. You will typically have a fever or high temperature (over 38C/100.4F) and two or more of the following:
- unusual tiredness
- headache
- runny nose
- sore throat
- shortness of breath or cough
- loss of appetite
- aching muscles
- diarrhoea or vomiting
Most pregnant women will have only mild symptoms and recover within a week. However, there is evidence from previous flu pandemics that pregnant women are more likely to develop complications.
Possible complications are:
- pneumonia (an infection of the lungs)
- difficulty breathing
- dehydration
In pregnant women, these are more likely to happen in the second and third trimester.
If a pregnant woman develops a complication of H1N1 flu, such as pneumonia, there is a small chance this will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.
It is, therefore, important to be well prepared and to take precautions against H1N1 flu.
Vaccination and pregnancy
Pregnant women are advised to take the seasonal flu jab, whatever the stage of pregnancy. This includes pregnant women not in high-risk groups.
This year's seasonal flu jab offers protection against the H1N1 (swine flu) virus, as well as other strains of flu virus.
There is no evidence that inactivated vaccines, such as the seasonal flu vaccine, will cause any harm to pregnant women or their unborn baby. Every year, the seasonal flu vaccine is given to pregnant women who are at risk of flu.
The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has given a clear recommendation that the GlaxoSmithKline vaccine Pandemrix can be given safely to all pregnant women.
Special precautions
If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible.
Pregnant women should also follow the general advice outlined in the box, top right. Good hygiene is essential.
If you think you may have H1N1 flu, call your doctor for an assessment. Your doctor will advise you what to do if they think you have flu.
Unless you have H1N1 flu symptoms, carry on attending your antenatal appointments to monitor the progress of your pregnancy.
H1N1 flu treatment
Antivirals
If you are pregnant and diagnosed with H1N1 flu, you may be given a course of antiviral drugs.
If you have an uncomplicated illness due to influenza and do not have an underlying disease, you can take either Relenza or Tamiflu. Relenza is recommended as a first choice.
Relenza is inhaled using a disk-shaped inhaler. It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta. Relenza should not affect your pregnancy or your growing baby.
However, Tamiflu should be offered instead of Relenza if you:
- have a condition such as asthma or chronic obstructive pulmonary disease
- have difficulty taking an inhaled antiviral
- develop a severe or complicated disease due to influenza (where you will probably be treated in hospital)
An expert group reviewed the risk of antiviral treatment in pregnancy. It is much smaller than the risk posed by the symptoms of H1N1 flu.
Some people have had wheezing or serious breathing problems when they have used Relenza. Relenza is therefore not recommended for people with asthma or chronic obstructive pulmonary disease (COPD). Other possible side effects of Relenza include headaches, diarrhoea, nausea and vomiting.
In a small number of cases, nausea is a side effect of Tamiflu.
If you take an antiviral and have side effects, see your healthcare professional to check that you are OK.
Painkillers
You can also take paracetamol to reduce fever and other symptoms. This is safe to take in pregnancy.
However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).
