Common Cold

What is a common cold?

Common cold is viral infection that affects mostly the upper respiratory tract, giving you nasal congestion, a swollen inner lining of your nose (rhinorrhea), a runny nose typically with sneezing, and often a dripping of mucus from the back of the nose down to your throat, which can cause a sore throat and coughing or a throat tickle that causes small coughs or an urge to clear your throat. You also can feel tired and have a low-grade fever. Colds are caused by a group of viruses called rhinoviruses, which have in common the characteristic that they thrive at the temperature of the lining of your nose, which is a little bit colder than core body temperature, but they dont survive at core body temperature, so the infection does not penetrate deeper into the body. Each time that you catch a cold, your immune system learns how to protect you against that particular rhinovirus, but you catch colds throughout life because each cold is caused by a different rhinovirus. Because there are so many, there are always colds circulating around the community that you have never had, so you are susceptible throughout life, including while you are pregnant. Generally, a cold lasts 7-10 days, but sometimes your symptoms can drag on longer because you have actually been infected with more than one rhinovirus at different points in time.

How common is common cold during pregnancy?

Common cold is an extremely common condition. Virtually everybody suffers a cold at some point, so the frequency of colds is described not in terms of the percentage of people that get them, but rather as how many colds people get. The tendency to have a cold is high in children, decreases with age since you already have had more of the cold viruses that are circulating in the community, and then increases a bit in the elderly, because of decreasing power of the immune system. The typical adult gets 2 3 colds per year, and since pregnancy is 40 weeks long, the odds favor you having a cold at some point during pregnancy. Colds can occur during any season of the year, but they are more common in winterish times (late September through May in temperate areas of the northern hemisphere) because people are enclosed in buildings and public transportation that have closed windows and often are overheated. This leads to dried mucous membranes, which decreases ones defense against rhinoviruses that are particularly concentrated in the enclosed spaces. The chances of catching a cold also increase for those with certain occupations, such as teaching young children and working in a daycare.

How is a cold diagnosed?

A common cold is diagnosed based on your history and physical exam, which would show a runny nose, sneezing, and other typical cold symptoms. In addition to observing these symptoms, your doctor also will need to rule out a host of conditions that either can resemble a cold, or can develop as a complication of a cold. Such conditions include bacterial infections of the middle ear (otitis media), throat, and sinuses, influenza (the flu), asthma, allergic rhinitis (hay fever), bronchitis, and pneumonia. Much of this ruling out process can be achieved through history and physical exam and simple lab tests, which can involve examining your ears with an otoscope, swabbing your throat, testing you for flu viruses, and listening to your lungs and airways with a stethoscope. If pneumonia is suspected you also would be asked to provide a sputum sample. Another test that is crucial for a pregnant woman who is coughing is a DNA sequence analysis for the bacterial species Bordetella pertussis if she has not received a Tdap vaccine.

Does a cold cause problems during pregnancy?

An uncomplicated cold is a nuisance during pregnancy that generally will resolve within 7-10 days. Complications can develop, however, that can be serious problems. These include bacterial infections of the middle ear, throat, or lungs, all of which can give you a high fever, which can lead to dehydration, and problems, sometimes long-term problems, in various organ systems. Bacterial sinusitis is another common complication that can lead to high fever. Even in the absence of complications, the dripping in the back of your throat and coughing of a common cold can disrupt your sleep cycle.

Does a cold during pregnancy cause problems for the baby?

If your cold gives you a fever, and especially if you develop a high fever due to a bacterial infection complicating your cold, its possible that this can lead to problems for the developing baby. Some studies have suggested that fever during pregnancy can increase a babys risk of having congenital defects involving the heart and other organs. Also, 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:

• The risks to yourself and your baby if you do not treat the cold
• 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 common cold during pregnancy?

There is no medication available to combat rhinoviruses, but several different families of drugs are given to treat the symptoms of a cold. First-generation antihistamines (such as triprolidine, diphenhydramine, and chlorpheniramine) can give short-term relief of the throat tickling, sneezing, and dripping. These are thought to be safe during pregnancy. Oral decongestants (pseudoephedrine, phenylephrine) can reduce sneezing and nasal stuffiness, as can topical decongestants that you inhale into the nose. There are three main categories of antipyretic (fever-fighting) drugs. One group consists of acetaminophen in the United States and paracetamol in several other countries. Another group is called non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, naproxen, and many others. Along with being antipyretic, NSAIDs also reduce inflammation. The third group, called salicylates, includes aspirin, which technically is also a kind of NSAID, because it reduces inflammation. There is concern that NSAIDs and salicylates may be harmful to the developing baby, but acetaminophen and paracetamol are thought to be safe.

Who should NOT stop taking medication for a cold during pregnancy?

Most pregnant women who need acetaminophen or paracetamol to eliminate fever during pregnancy should not stop taking the drug, because there is concern that fever could be harmful to the developing baby. The exc
eption is for women who have liver problems, but having liver problems in the first place already makes successful pregnancy very challenging.

What should I know about choosing a medication for my cold during pregnancy?

You may find Pregistrys expert reports about the individual medications to treat cold symptoms here. Additional information can also be found in the sources listed at the end of this report.

What should I know about taking a medication for my common cold when I am breastfeeding?

Acetaminophen, paracetamol, NSAIDs, and antihistamines are thought to be relatively safe in mothers who breastfeed.

What alternative therapies besides medications can I use to treat my cold during pregnancy?

Inhalation of heated humidified air may reduce nasal obstruction, as may nasal irrigation with sterile saline. Drinking warm liquids can soothe a sore throat and help keep you hydrated.

What can I do for myself and my baby when I have a cold during pregnancy?

Get plenty of rest, keep yourself hydrated, and treat your symptoms as needed.

Resources for common colds in pregnancy:

For more information about common colds during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:

• Mayo Clinic: Common Cold
• Cleveland Clinic: Medication in Pregnancy