title: Influenza and its treatment during pregnancy: A review.
abstract: The influenza viral infection has dramatic effects during pregnancy on the mother and the fetus. We present a review article on the prevention and treatment recommendations of influenza infection in pregnant women, and the effects of antiviral medications on maternal-fetal outcomes. This viral infection not only leads to miscarriages, preterm deliveries and a high maternal mortality rate, but it also poses negative risks to the fetus including small-for-gestational age infants, and admissions to neonatal intensive care units. Vaccination is the most effective strategy for preventing influenza infection during pregnancy whereby can protect both maternal and fetal immunities. The safety profiles of antiviral drugs during pregnancy are limited. Available risk-benefit evidence has indicated that pregnant women with suspected or confirmed influenza should receive prompt antiviral therapy where these medications reduce the risk of complications among pregnant women, and attenuate the teratogenic effects of the influenza infection. Post-exposure prophylaxis is not recommended for most pregnant women, but it may be prescribed in pandemic settings, particularly to non-vaccinated women. Although some ex vivo models for pharmacokinetic studies have revealed that the transplacental transfer of oseltamivir to fetal circuits may occur, there is no evidence of adverse fetal outcomes as a result of most in utero exposures to neuraminidase inhibitors. Due to the large number of confounding variables, large, population-based studies are needed to assess the association between in utero oseltamivir exposure and fetal outcome.
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Centerm Beirut, Lebanon.
authors.forename: L M
authors.initials: LM
authors.lastname: Ghulmiyyah
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Centerm Beirut, Lebanon.
authors.forename: M M
authors.initials: MM
authors.lastname: Alame
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Centerm Beirut, Lebanon.
authors.forename: F G
authors.initials: FG
authors.lastname: Mirza
authors.affiliation: Department of Experimental Pathology, Immunology & Microbiology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: H
authors.initials: H
authors.lastname: Zaraket
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Centerm Beirut, Lebanon.
authors.forename: A H
authors.initials: AH
authors.lastname: Nassar
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000188:drug therapy* / Q000517:prevention & control*; D026901:Membrane Transport Proteins / Q000187:drug effects; D053139:Oseltamivir / Q000493:pharmacokinetics / Q000627:therapeutic use; D056990:Post-Exposure Prophylaxis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000517:prevention & control*; D011256:Pregnancy Outcome; D014611:Vaccination; D053243:Zanamivir / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D007252:Influenza Vaccines; D026901:Membrane Transport Proteins; D053139:Oseltamivir; D053243:Zanamivir
keywords: Pregnancy; influenza; oseltamivir; pharmacokinetics; treatment