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Pregnant women and swine flu (Updated)

June 17, 2009 | 12:12 pm

Flu can be especially dangerous in pregnant women, especially during the third trimester. The Centers for Disease Control and Prevention and the World Health Organization recently warned that pregnancy may be a risk factor for contracting H1N1 swine flu, which has reached pandemic levels. According to the CDC, there have been 20 recent H1N1 infections in pregnant women in the United States (15 probable cases and five confirmed cases). Of those, three women were hospitalized and one died. A woman's immune system is somewhat weaker during pregnancy. That means those who become infected with flu are more likely to develop serious complications, like pneumonia.

The medications Tamiflu and Relenza are relatively safe for use in pregnant and breast-feeding women, according to an analysis from the top research group in the world on pregnancy and toxic exposures.

The Motherisk Program at the Hospital for Sick Children in Toronto studies the delicate issue of which medications are safe for use during pregnancy and which environmental exposures are likely to harm a fetus. In the new issue of the Canadian Medical Assn. Journal, researchers concluded that although there are minimal data, Tamiflu does not appear to cause birth defects. Relenza also appears to be safe, although there is less evidence. Both Tamiflu and Relenza are considered safe for use during breast-feeding.

Women whose third trimester will overlap with the coming flu season should be especially careful to avoid exposure to flu. The CDC has a Web page with advice on flu protection. Flu vaccination is usually recommended for pregnant women as well. A vaccine for H1N1 is in development.

[Updated at 11:40 a.m.:  Information on flu shots for pregnant women, including access to free shots, is available at the National Women's Health Resource Center and the Assn. of Women's Health and Obstetric and Neonatal Nurses. Go to: "Flu-Free and a Mom-to-Be: Protect Yourself, Protect Your Baby, Get a Flu Shot!"]

-- Shari Roan