The risk of morbidity from influenza is higher in pregnant women, particularly in those in the final trimester, and mortality rates have historically been higher in this patient group in past pandemics. This increased risk should be taken into account when caring for affected patients, the researchers say.
Safety data on the use of antivirals in pregnancy is limited, and the drugs are not licensed for use in pregnant women.
However, analysis of data from two Japanese teratogen information services on 90 pregnant women who took therapeutic doses of oseltamivir during the first trimester found no evidence of increased risk of malformation associated with oseltamivir use.
The HPA in its guidance on treatment for suspected H1N1 flu states that the benefits of antiviral treatment outweigh the risks. It recommends pregnant women exposed to the H1N1 virus be treated with zanamivir where possible because it reaches low concentrations in the blood.
Where zanamivir is contraindicated, oseltamivir should be prescribed.
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