Treatment of Influenza in Pregnancy and Within 2 Weeks Postpartum
Influenza presenting during pregnancy or within 2 weeks of delivery is a distinct clinical scenario. Physiological changes associated with pregnancy directly affect how different antiviral treatment routes perform, making route selection a key clinical decision in this population.
This protocol applies to pregnant women at any trimester and to those within 2 weeks postpartum. Pregnancy alters respiratory physiology in ways that affect drug distribution through certain routes of administration, and safety data for some treatment options in this population remains limited — both considerations shape the approach to antiviral selection.
Oral antiviral therapy is the preferred route in this population. Concerns about lower lung volumes in pregnancy — affecting inhaled drug distribution — as well as bronchospasm risk, steer the choice away from the inhaled alternative. Limited pharmacokinetic and safety data for the intravenous option in pregnant women similarly favour the oral route.
Reduction in the duration of fever and influenza symptoms.
References
DOI: 10.1093/cid/ciy866
- Pregnant women and those within 2 weeks postpartum (A-III).
- Oseltamivir is preferred for treatment of influenza in pregnant women over inhaled zanamivir because of concerns about lower lung volumes resulting in reduced drug distribution and concerns about bronchospasm.
- Oseltamivir is also preferred over IV peramivir because of the dearth of pharmacokinetic or safety data for peramivir in pregnant women.