The Swine Flu and You:
What Every Expectant Mother Should Know
By Charles Hux, MD
(Posted 10/20/09)

With the H1N1 vaccine just recently made available, one of the first “high-risk” groups to have the vaccine available to them will be pregnant women. As only 15 percent of pregnant women get vaccinated against the seasonal flu each year, even more are nervous about getting the H1N1 vaccine.

There is a new strain of flu virus called the H1N1 or swine flu virus. This virus is quickly spreading throughout the world, causing much worry and fear among the general population and the medical community. Over 90% of flu cases this year will be caused by the H1N1 strain of virus.

As with the most strains of the flu virus, young children, the elderly, those with comprised immune systems and pregnant women are especially at risk. The H1N1 strain of flu carries a greater risk of complications and death compared to the traditional flu. This is due to the fact that the H1N1 virus causes more severe respiratory complications much faster.

As a maternal-fetal medicine specialist, I am very concerned that pregnant women understand the dangers of not being vaccinated for both the seasonal flu and particularly the H1N1 strain of virus. Pregnancy weakens a woman’s immune system making her more susceptible to catching viruses. A pregnant woman who already suffers from asthma or another chronic respiratory condition is at a greater risk for complications. There is an 8 percent or 1 in 12 risk of death if, a pregnant women becomes infected with the H1N1 virus.

In addition, if a pregnant woman needs to go to the hospital and ends up on mechanical ventilation due to respiratory complications, the baby can suffer from decreased oxygen. This has the potential of causing neurological damage to the baby.

It is also important to note that the majority of pregnant women who did not survive after contracting the swine flu were otherwise healthy.

Getting both the H1N1 and seasonal flu vaccine is the best protection you can have to avoid contracting the flu. You should get both vaccinations to be fully protected. These vaccinations will also give protection to your unborn baby for the first six months of life.

It is best to get both the vaccines before you become pregnant or if you are already pregnant in the first trimester of pregnancy. If possible it is important to try to avoid getting sick with an illness that will produce a fever, especially in the first trimester of pregnancy.

Having a fever in the first trimester doubles the risk of having a baby with a neural tube defect such as spina bifida. In addition, women who contract the swine flu are at a higher risk of a premature delivery.

Both vaccines can be given on the same day, but should be given in different locations such as one in your right arm and one in your left arm. The nasal spray vaccination should be avoided during pregnancy as it contains live virus. If you have suffered from a recent illness you should check with your physician as to when it is safe to get the vaccine.

The side effects from the H1N1 vaccine are similar to those from the seasonal flu vaccine. Side effects include soreness, redness, and swelling at the injection site. Some women may experience muscle aches, headache, low-grade fever and nausea. These symptoms should disappear in 1-2 days.

Many pregnant women are afraid that the H1N1 vaccine is neither safe for themselves or their unborn baby. The H1N1 vaccine is made in the same way, in the same facilities as the seasonal flu vaccine. The main difference is that a different strain of inactivated or killed virus is used. The seasonal flu vaccine has been used for many years on pregnant women with no short or long-term risks to the mother-to-be or baby.

A big concern among pregnant women is that receiving any type of vaccine during pregnancy will increase the chance that their unborn baby will be autistic due to the mercury content in the vaccine. The amount of mercury (thimerosal) in a single dose shot is extremely small, less than the amount in one spoon of canned tuna. However, several million doses without mercury will be made available for pregnant women.

Unfortunately, many pregnant women will not heed the advice of their physicians and will not receive the H1N1 vaccine. It is therefore very important to try to do what you can to prevent yourself from contracting this virus. There are certain steps that you can take to make you less susceptible and these include the following:

• A nutritious diet should be eaten that is rich in fruits and vegetables.
• Supplementing your diet with extra vitamin C D.
• Washing you hands frequently.
• Keeping your hands away from your mouth and eyes.
• Staying away from people you know are not feeling well.

If a pregnant woman thinks she is coming down with the flu it is important that you contact your doctor immediately. Common symptoms of the flu include:

• Fever (affects over 90% of people)
• Cough
• Sore throat
• Stuffy/Runny nose
• Body aches
• Headache
• Chills
• Diarrhea/Vomiting

It is important to see your doctor as soon as possible to get an anti-viral medication. If you doctor is not available, you should go to your local medical center for treatment. This will lessen the symptoms, which will reduce the chance of serious complications and also shorten the duration of the illness.

There is no risk to either the mother or baby from this anti-viral medication. The real danger comes from having an untreated case of the H1N1 virus while being pregnant.

The benefit of receiving the H1N1 and seasonal flu vaccine far outweighs the risks of contracting the virus. This is a very serious virus that will kill nearly 40,000-50,000 this year. If you are pregnant, make sure that you get vaccinated as soon as possible.

Dr. Charles Hux attended Case Western Reserve School of Medicine and completed his residency in obstetrics and gynecology and a fellowship in maternal-fetal medicine at Thomas Jefferson University. He received a master’s degree in genetics from Rutgers University. He maintains a private practice and is primarily affiliated with Monmouth Medical Center.

His articles have appeared in American Journal of Obstetrics/Gynecology, Prenatal Diagnosis, New England Journal of Medicine and Genetics. He is the author of the new book, Nine Healthy Months.

For the last eight years, he has been the current resident “multiples doctor” on The Learning Channel’s A Baby Story.

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