What is bronchitis during pregnancy?
Bronchitis is inflammation of the mucous membrane lining the inside of the bronchi, the two tubes that lead from the trachea (which leads down from the throat) to the lungs. Bronchitis is characterized by spasms of the smooth muscle layer within the bronchi, with coughing, and often mucus secretion, and can be acute or chronic. Acute bronchitis usually results from infections with viruses that cause the common cold (rhinoviruses, coronaviruses, respiratory syncytial virus [RSV], parainfluenza) or influenza virus (the flu), and sometimes from a bacterial infection. In fact, its possible to have some degree of pneumonia an infection in the lungs, often due to bacteria alongside bronchitis. Bronchitis is called chronic if your cough lasts for periods measured in months, or if the condition waxes and wanes over at least two years. In cases of chronic bronchitis, airway lining is inflamed continuously, so there is typically a lot of mucus. Chronic bronchitis can be a component of chronic obstructive pulmonary disease (COPD), a severe condition, and any of these conditions can occur during pregnancy.
How common is bronchitis during pregnancy?
Bronchitis has been reported to develop in millions of people each year in North America, especially in the fall and winter, and is at least as common among pregnant women as it is in the general adult population. You have an elevated risk of developing acute or chronic bronchitis, if you smoke, or suffer from asthma or allergies. History of respiratory conditions in your childhood, family history of respiratory conditions, and gastroesophageal reflux disease (GERD) also increase your risk. Smoking is a particularly high-risk factor for chronic bronchitis.
How is bronchitis during pregnancy diagnosed?
The diagnosis of bronchitis begins with the medical history and physical examination to evaluated symptoms and signs. This can include coughing, mucus production, breathing difficulty, chest pain, wheezing, and low-grade fever. This will lead your doctor to order a chest x-ray (CXR) to determine whether you have pneumonia and also to look at your bronchi. Although it is common for pregnant women to fear CXR on account of ionizing radiation, and even many primary care physicians hesitate to order CXR in pregnant women, there is no rationale for avoiding CXR during pregnancy; the ionizing radiation dose is very low and modern x-ray beams are extremely focused and well-aimed. Your doctor may also order blood tests and a sputum sample to evaluate you for infection and the need for antibiotics.
Does bronchitis cause problems during pregnancy?
Bronchitis makes you cough and produces mucus, plus you may suffer breathing difficulty, chest pain, and fever, as well as body aches and fatigue, as when you have the flu. Thus, you could also develop a headache and sinusitis.
Does bronchitis cause problems for the baby?
Bronchitis in a pregnant woman usually is not directly harmful to the baby. However, the condition can cause problems indirectly, if it gives you a fever. Although more data are needed, some studies have suggested that fever during pregnancy can increase a babys risk of having congenital defects involving the heart and other organs or a neural tube defect (bone and other connective tissue layers do not close completely over the central nervous system). Furthermore, a recent study identified maternal fever as a possible risk for the baby developing autism spectrum disorder.
What to consider about taking medications when you are pregnant or breastfeeding:
- The risks to yourself and your baby if you do not treat the bronchitis
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat bronchitis during pregnancy?
Your physician will recommend antipyretic (fever-fighting) medication if you have a fever with your bronchitis. Such medication includes acetaminophen in the United States and paracetamol in several other countries. Another class of medications is called non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, naproxen, and other drugs. Along with being antipyretic, NSAIDs also reduce inflammation, so they may help somewhat to improve bronchitis symptoms. A third group of medications, called salicylates, includes aspirin, although, technically, aspirin is a kind of NSAID, because it reduces inflammation. Acetaminophen and paracetamol are thought to be fairly safe throughout pregnancy, but NSAIDs (such as ibuprofen, naproxen) and salicylates (such as aspirin) should be avoided, particularly toward the end of pregnancy. Thats because there is increasing risk as pregnancy advances.
Only if your viral infection is accompanied by a bacterial infection, such as in the lungs (pneumonia) or in your sinuses (bacterial sinusitis), will the doctor prescribe antibiotic medication. Nonprescription medicines that loosen mucus also can be useful and are not thought to be harmful to the baby. Antibiotics that are effective in such cases, and that are considered safe in pregnancy include (but are not limited to) clindamycin, ampicillin, amoxicillin, various cephalosporins (such as cefaclor, cephalexin), erythromycin, and nitrofurantoin.
Who should NOT stop taking medication for bronchitis during pregnancy?
Most pregnant women who need acetaminophen or paracetamol to eliminate fever resulting from bronchitis during pregnancy should not stop taking the drug, because there is concern that fever could be harmful to the fetus, or embryo. The exception is in women who have liver problems, although having liver problems in the first place already makes successful pregnancy very challenging. If you are prescribed an antibiotic for a bacterial infection, you should continue it for as many days as instructed. However, if you have a reaction to an antibiotic you must notify your doctor who can switch you to a different one.
What should I know about choosing a medication for my bronchitis during pregnancy?
It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.
You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.
What should I know about taking a medication for my bronchitis when I am breastfeeding?
Acetaminophen, paracetamol, and NSAIDs are thought to be relatively safe in mothers who breastfeed.
What alternative therapies besides medications can I use to treat my bronchitis during pregnancy?
Quitting smoking will remove one major aggravator of the bronchi that leads to inflammation and particularly chronic bronchitis. Breathing humidified air from a humidifier, from hot drinks and soup, and from a hot shower also can help.
What can I do for myself and my baby when I have bronchitis during pregnancy?
It is very important to follow the instructions of your physician.
Resources for bronchitis in pregnancy:
For more information about bronchitis during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations: