Take Action Against Respiratory Viruses Like RSV for a Healthy Pregnancy

Respiratory viruses such as RSV, flu and coronavirus, as well as the disease of asthma, pose risks during pregnancy

The fertility specialists at Tennessee Reproductive Medicine (TRM) emphasize the importance of understanding the impact of respiratory viruses and other issues like asthma on our patients who become pregnant. Efficient breathing during pregnancy helps deliver proper levels of oxygenated blood to the baby. Anything that impedes that can cause problems for the mother and the baby.

Respiratory viruses, which are the most frequent cause of disease in all humans, present more of a problem for pregnant women than nonpregnant women.

Changes in a woman’s immune system, lungs and heart during pregnancy can increase the risk of serious illness from respiratory viruses for the mother and her child. Here are some key statistics from The Centers for Disease Control and Prevention (CDC):

• From 2010-2019, 28% of reproductive age women hospitalized for the flu were pregnant.
• The odds of intensive care admissions for COVID-19 in pregnant women were 2.5 times higher than for nonpregnant women of reproductive age.
• Flu vaccination during pregnancy reduces the risk of hospitalization for infants under 6 months old by 40%.
• RSV vaccination during pregnancy reduces infant hospitalization by 50%.

These alarming statistics are why the medical staff at TRM counsels our patients who become pregnant, and those undergoing fertility treatments to become pregnant, on the risks from respiratory viruses for themselves and their child. Let’s delve into vital considerations regarding respiratory viruses and their implications during pregnancy.

RSV vaccine protects pregnant mothers, their child & those undergoing fertility treatment

Respiratory syncytial virus (RSV) poses a significant threat to everyone and is of particular concern during pregnancy. RSV usually causes symptoms of a cold lasting 1-2 weeks, but research indicates pregnant women with RSV are more apt to develop severe symptoms due to weakened heart and lung function during pregnancy. Risks in pregnancy from RSV include:

• Preeclampsia (high blood pressure).
• Pneumonia.
• Sepsis.
• Respiratory failure.

Not every pregnant woman with RSV will have severe symptoms. But we caution every pregnant woman to be aware of the risks of RSV, which can harm the mother and the child. Women with preexisting lung disease including asthma are at greater risk of severe issues from RSV.

The child of a pregnant mother is also at risk from RSV, which is transmitted to the fetus through the infected mother’s placenta. Potential health problems for the child include low birthweight, developing lung issues later in childhood, and risk of severe cases of RSV after birth, due to the virus causing preterm delivery.

TRM strongly recommends the RSV vaccine for pregnant women and individuals undergoing fertility treatment to shield both the mother and the developing baby from potential complications associated with the virus. The Food and Drug Administration approved the RSV vaccine for pregnant women in August of 2023. It protects pregnant women and their child (from birth to 6 months of age) from severe lower respiratory tract disease due to RSV.

Uncommon dangers for pregnant women from the common flu respiratory virus

Influenza (flu) is a common respiratory virus that also carries increased risk of complications for pregnant women due to changes in their immune system. The American College of Obstetricians and Gynecologists reports that the flu increases pregnant women’s risk of preterm labor and birth, which can cause serious problems for the woman and her child.

Pregnant women are more likely to be hospitalized with the flu than nonpregnant women. The risk of dying from the flu is also higher in pregnant women.

We encourage pregnant women to get the flu vaccine

The CDC recommends that pregnant women or those who will become pregnant during flu season be vaccinated against the flu. They should receive inactivated influenza vaccine or recombinant influenza vaccine. They should not get a live attenuated influenza vaccine.

The vaccine protects the pregnant mom’s child from influenza respiratory virus as well. The antibodies are transferred from the mother to her fetus. This is important because after birth, the child cannot receive a flu vaccine until 6 months of age.

How asthma and pregnancy affect mother & newborn

Asthma exacerbations during pregnancy heighten the risk of complications for both the mother and the baby. It’s imperative for pregnant women with asthma to effectively manage their condition with help from their OB/GYN.

Up to 45% of pregnant women with asthma have an asthma attack during the pregnancy, according to the American Lung Association. For some women, their asthma does not change during pregnancy, and for some it may improve.

We advise women with asthma to work with their healthcare providers to manage asthma during pregnancy. This includes controlling asthma symptoms and maintaining regular activity and lung function in order to prevent attacks.

Asthma attacks while pregnant can decrease the oxygen in the mother’s blood and thus in the baby’s blood. Asthma during pregnancy can increase the risk of premature birth and low birth weight, which may lead to health problems for the newborn such as breathing issues, ongoing disabilities, developmental problems and cerebral palsy. Asthma during pregnancy puts the mother at increased risk for preeclampsia and C-section birth.

For expectant mothers grappling with asthma, respiratory viruses like RSV can pose heightened challenges.

Asthma inhaler concerns during pregnancy

Most medications for asthma are inhaled. With an asthma inhaler, the medication goes straight to the lungs and does not enter the blood stream of the mother. Most of the medication does not reach the baby she carries.

Asthma inhalers serve as a common treatment for asthma, but pregnant women may have concerns due to the use of steroids in many inhalers. Inhaled steroids are generally considered safe during pregnancy at commonly prescribed doses. TRM advises women to discuss any apprehensions with their healthcare providers. They can offer personalized guidance on the appropriate use of inhalers to manage asthma symptoms while minimizing potential risks to the developing baby.

Protecting against respiratory viruses throughout pregnancy

Maintaining optimal respiratory health is vital during pregnancy for both maternal well-being and fetal development. TRM encourages practicing good hygiene, such as frequent handwashing and avoiding close contact with sick individuals, to reduce the risk of respiratory infections. Additionally, staying updated on vaccinations, including the RSV, flu and Covid vaccines, is crucial for protecting against preventable illnesses.

If you have asthma or concerns about respiratory viruses during pregnancy or fertility treatment, TRM encourages reaching out to your healthcare providers. We can advise you during fertility treatments, and your OB/GYN can take over when you become pregnant.