No Need to Panic About Influenza During Pregnancy, Oseltamivir Can Be Used Safely

During pregnancy, immunity decreases, and once influenza strikes, many expectant mothers face a dilemma: taking medication may worry them about affecting the baby, while not taking it raises concerns about worsening the condition. In fact, when dealing with influenza, timely and appropriate medication is crucial. Oseltamivir is a "reassuring choice" for treating influenza during pregnancy.

Safety of Oseltamivir

First, let’s discuss the safety of oseltamivir. Although it is classified as an FDA Pregnancy Category C drug (potential risks in animal studies but lacking human research data), extensive real-world clinical data provides reassuring answers. Roche’s database shows that among 232 pregnant women who used oseltamivir during pregnancy, the spontaneous abortion rate was 6.1% and the preterm birth rate was 2.1%, which are consistent with the background rates in normal pregnant women. No clear association between the drug and serious birth defects was found. Studies cited in the 2019 "Expert Consensus on Influenza Prevention and Treatment in Pregnant Women" also confirm that using oseltamivir during pregnancy does not increase the risks of preterm birth, low birth weight, or congenital malformations.

Threat of Influenza to Pregnant Women

Next, consider the threat of influenza to pregnant women, which is far greater than the risks of medication. Data from the World Health Organization and the Chinese Center for Disease Control and Prevention show that pregnant women are 3.3 times more likely to contract influenza than the general population, with even higher risks in the third trimester and significantly increased hospitalization and intensive care rates. During the 2009 H1N1 influenza pandemic, pregnant women accounted for 10.5% of severe cases and 19.2% of deaths. Influenza can also lead to complications such as pneumonia and respiratory failure, and may even cause preterm birth, fetal distress, or intrauterine fetal death. These consequences are far more severe than the potential risks of oseltamivir.

How to Use Oseltamivir During Pregnancy

So, how should oseltamivir be used during pregnancy? The key is "early".

• Timing of Medication: The best treatment effect is achieved when started within 48 hours of the onset of influenza symptoms (such as high fever, body aches, fatigue, dry cough, etc.). Even if more than 48 hours have passed, severe patients can still benefit from the medication.
• Treatment Dosage: Take 75mg twice daily for 5 consecutive days, the same as the dosage for non-pregnant adults. No adjustment is needed based on gestational age.
• Preventive Medication: If you have been in close contact with an influenza patient and wish to prevent infection, take 75mg once daily for at least 7 days.

Medication Precautions

There are also small details to note when taking the medication:

• Taking it with food can alleviate gastrointestinal discomfort such as nausea and vomiting.
• If you are taking other medications like probenecid or warfarin, inform your doctor in advance to avoid drug interactions.
• Although rare, if hallucinations, convulsions, or other abnormalities occur during medication, seek medical attention promptly and avoid driving or operating precision instruments temporarily.
• If fever exceeds 38.5°C, acetaminophen can be used for fever reduction, but avoid ibuprofen and aspirin.

Prevention Is More Important Than Treatment

Of course, preventing influenza is more important than treating it.

• Vaccination: Receiving an inactivated influenza vaccine during pregnancy is particularly crucial. It not only reduces the risk of influenza infection by 60% in pregnant women but also transfers antibodies to the baby through the placenta, achieving "protection for two with one vaccination."
• Daily Protection: Wash hands frequently, ensure good ventilation, avoid crowded places, maintain a balanced diet, get enough sleep, and strengthen your immune system.

Conclusion

Finally, it is important to remind that there is no need to hesitate about using medication for influenza during pregnancy. Doctors will conduct a comprehensive assessment based on gestational age, severity of the condition, and other factors. Timely use of oseltamivir can control influenza symptoms while ensuring the safety of both mother and baby. Do not delay treatment due to concerns about medication risks, giving influenza an opportunity to take hold.