Flu While Pregnant

Overview

What is flu in pregnancy?

Influenza (flu) is a common respiratory infection that mostly occurs in winter. It’s caused by a virus that easily travels from person to person. When someone with the flu coughs, sneezes or speaks, the virus spreads through the air and on surfaces.

Flu during pregnancy is more likely to cause severe illness than flu in nonpregnant people. Pregnant people who get the flu are also more likely to be hospitalized for treatment. If you're pregnant and have the flu or flu-like symptoms, see your healthcare provider.

Who is more likely to get the flu?

You’re at higher risk of flu during pregnancy than when you’re not pregnant. That’s because pregnancy naturally suppresses your immune system, which is your body’s defense against illness. This suppression increases your risk of infections, including the flu.

Pregnant people who aren't vaccinated against the flu have a higher chance of getting it compared to vaccinated pregnant people. Studies show that flu vaccines lower the risk of flu infection in pregnant people by 50%.

If I get the flu while pregnant, does my baby get sick, too?

Getting the flu during pregnancy can affect your baby’s development. Fever, a common flu symptom, can cause neural tube defects and other problems in a developing baby.

Can the flu cause miscarriage?

Studies have shown that flu during pregnancy increases your risk of miscarriage, premature birth and low birth weight.

Symptoms and Causes

What causes the flu in pregnancy?

The same virus causes the flu in pregnant and nonpregnant people. The flu virus infects your lungs, nose and throat, causing respiratory symptoms similar to a cold. You can get the flu by inhaling the virus through the air or by touching something that has the flu virus on it.

The flu is contagious beginning one day before symptoms start and five to seven days after feeling sick. That means you can spread the flu to others before you even know you’re ill.

What are the symptoms of flu during pregnancy?

The most common symptoms of flu while pregnant include:

Diagnosis and Tests

How is flu during pregnancy diagnosed?

To diagnose the flu, your healthcare provider may use a flu (influenza) test such as:

  • Rapid influenza diagnostic test (RIDT): This test shows results in 10 to 15 minutes.
  • Rapid molecular assay: This test shows results in 15 to 20 minutes.

Your healthcare provider will wipe the inside of your nose or the back of your throat with a long cotton swab. The test should be quick and painless.

Management and Treatment

How is the flu treated during pregnancy?

When diagnosed early, your healthcare provider may prescribe an antiviral medication. While antivirals don’t cure the flu, they can stop symptoms from getting worse. Many providers prefer the oral antiviral oseltamivir (Tamiflu®) for pregnant people. It has the most studies verifying its safety.

Talk to your provider about other medications you can safely take during pregnancy. These may include:

  • Acetaminophen (Tylenol®) to reduce flu symptoms, especially fever.
  • Dextromethorphan (Robitussin®-DM or Delsym®), guaifenesin (Mucinex®) or cough drops to relieve respiratory symptoms.

How can I treat the flu at home while pregnant?

Flu symptoms can last for a week or more. Make sure to rest and drink plenty of fluids to avoid dehydration. Take over-the-counter medications such as acetaminophen to help relieve symptoms. Follow the instructions on all medications, including prescriptions.

How soon after treatment for flu during pregnancy will I start to feel better?

If your healthcare provider prescribes an antiviral, you should start to notice symptom improvement within a day or two. Over-the-counter pain and fever medications can start helping right away.

You should notice an improvement in your symptoms within five to seven days. If you don’t start feeling better after a week, call your provider.

Prevention

How can I prevent flu in pregnancy?

The best way to prevent flu during pregnancy is by getting a flu vaccine, ideally before flu season starts. The Centers for Disease Control and Prevention (CDC) recommends that pregnant people get a flu vaccine any time during their pregnancy.

Many studies have proven the safety of flu shots for pregnant people. Millions of people have been vaccinated over the years. One study found that getting the flu vaccine lowered a pregnant person’s risk of being hospitalized with the flu by about 40%.

Studies also show that the flu vaccine helps protect your baby after they're born. Vaccine antibodies (blood proteins that helps fight viruses in your body) get passed to your baby during pregnancy. After birth, breastfeeding continues to give antibodies to your baby. This protection is important since babies can’t get a flu shot until they’re at least 6 months old.

Pregnant people should also follow general flu prevention best practices:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes or nose.
  • Clean surfaces at home and work with disinfectant.
  • Cover your mouth and nose.
  • Wash your hands frequently.

Is the flu shot safe during pregnancy?

Yes. Many studies have proven the safety and effectiveness of the flu vaccine during pregnancy. It's the single best protection against the flu for pregnant people.

Can a flu shot during pregnancy harm the baby?

No. The flu shot can benefit your baby during pregnancy. When you get this vaccine while pregnant, flu-fighting antibodies pass to your baby through the placenta. Breast milk delivers those same antibodies after birth, providing more protection from the flu.

Outlook / Prognosis

What is the outlook for someone with the flu while pregnant?

With early diagnosis and treatment, many pregnant people recover from the flu with no problems. But those who are pregnant have a higher chance of getting serious complications from the flu — sometimes requiring hospitalization.

Living With

When should I contact my healthcare provider about flu during pregnancy?

See your healthcare provider if you notice any flu symptoms or any symptoms that seem unusual or concerning.

Should I go to the ER if I have the flu?

Call 911 or go to the emergency room right away if you have any of these severe flu symptoms:

  • Decreased or no movement of your baby.
  • Dizziness, confusion or the inability to wake up.
  • Extreme weakness or unsteadiness.
  • Fever or cough that comes and goes or gets worse.
  • High fever that doesn’t change after taking acetaminophen.
  • No urine for an extended period.
  • Ongoing pain or pressure in the chest or abdomen.
  • Seizures.
  • Severe muscle pain.
  • Trouble breathing or shortness of breath.

How do I take care of myself when I have the flu while pregnant?

The best way to take care of yourself (and your baby) is to:

  • Follow your healthcare provider’s directions for any medications.
  • Rest.
  • Drink plenty of fluids to stay hydrated.
  • Avoid spreading the virus to others.

A note from Cleveland Clinic

Flu in pregnancy is a serious illness. See your healthcare provider if you notice any signs of the flu. Early treatment with antiviral medications can reduce symptom severity and help you feel better sooner. Getting a flu vaccine during pregnancy is a safe and effective way to protect yourself and your baby. Talk to your provider about getting a flu shot today.

Last reviewed by a Cleveland Clinic medical professional on 05/26/2022.

References

  • American Lung Association. Flu Symptoms, Causes, and Risk Factors. (https://www.lung.org/lung-health-diseases/lung-disease-lookup/influenza/symptoms-causes-and-risk) Accessed 5/26/2022.
  • American Pregnancy Association. Flu During Pregnancy. (https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/flu-during-pregnancy/) Accessed 5/26/2022.
  • Centers for Disease Control and Prevention. Multiple pages reviewed for this article. (https://www.cdc.gov/flu/symptoms/testing.htm) Accessed 5/26/2022.
  • March of Dimes. Influenza (Flu) and Pregnancy. (https://www.marchofdimes.org/complications/influenza-and-pregnancy.aspx) Accessed 5/26/2022.
  • National Institutes of Health Office of Research on Women’s Health. Pregnant Women & Influenza (Flu). (https://orwh.od.nih.gov/research/maternal-morbidity-and-mortality/information-for-women/pregnant-women-influenza-flu) Accessed 5/26/2022.
  • Thompson M, Kwong JC, Regan AK, et al. Influenza Vaccine Effectiveness in Preventing Influenza-associated Hospitalizations During Pregnancy: A Multi-country Retrospective Test Negative Design Study 2010-2016. (https://pubmed.ncbi.nlm.nih.gov/30307490/) Clin Infect Dis. May 1, 2019;68(9):1444–1453. Accessed 5/26/2022.

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