Whooping Cough


The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is whooping cough virus during pregnancy?

Whooping cough is a common name for pertussis, a respiratory disease caused by infection with a species of bacteria called Bordetella pertussis, which causes disease by attaching to small, hair-like extensions structures called cilia, which line upper airways. It is one of the most preventable dangerous infections that strike young children. Back in the 19th and early 20th centuries, it was one of a handful of infectious diseases that killed many children, especially in crowded cities with a lot of immigrants. This changed dramatically with the advent of the pertussis vaccine that today is combined with vaccines for tetanus and diphtheria (Tdap for adults, DTaP for young children). In poor countries, however, vaccination rates are low. Furthermore, in certain communities in wealthy countries, misunderstanding combined with misinformation spread by anti-vaccine activists has led to a lapse in vaccination rates, which potentially can be very dangerous. 

How common is whooping cough during pregnancy?

The US Centers for Disease Control and Prevention considers the incidence of pertussis among pregnant women to be unnecessarily high due to a finding that only approximately half of pregnant women have received the Tdap or up-to-date booster.

How is whooping cough during pregnancy diagnosed?

Often, doctors make a clinical diagnosis of whooping cough, meaning that a presumptive diagnosis is made based on the fact that you have not received a Tdap vaccine booster recently enough to maintain adequate immunity (or you were never vaccinated) and you develop a characteristic whooping cough that comes in intense episodes. A complete blood count (CBC) showing elevated white blood cell count (WBC) would indicate that your body is fighting an infection, which would support the diagnosis, but a definitive diagnosis can be made by swabbing your nose or throat and culturing the sample in the laboratory to see if B. pertussis grows. Along the way, you should have a chest X-ray to rule out pneumonia, which can develop as a complication.

Does whooping cough cause problems during pregnancy?

Pertussis cause whats called paroxysmal symptoms, meaning symptoms that come in intense episodes. These episodes feature a productive cough (a cough that brings up phlegm), which is so intense that often the person produces a whooping sound while inhaling sharply to take in air between coughs; this why it is called whooping cough. Such a cough can interfere with your daily activities, including getting a good nights sleep. Intense coughing also can trigger vomiting (which can cause electrolyte disturbances), and, if you have stress urinary incontinence (difficulty holding in urine when pressure increases in the pelvis, which is very common among pregnant women), the coughing can cause urine leakage. Along with, or in the days prior to the whooping cough, are common cold symptoms, such as a runny nose, watery eyes, sneezing, fatigue, and low-grade fever. Pertussis also can be complicated by dehydration, ear infection, and pneumonia.

Does pertussis cause problems for the baby?

The main danger of maternal pertussis for a baby is when the mother suffers from pertussis after the baby has already been born. This can happen when the mother develops whooping cough near the end of pregnancy, or after delivering. Pertussis causes severe respiratory disease in infants that is potentially fatal, and approximately 70 percent of such cases are the result of unvaccinated mothers.

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 whooping cough
  • 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 whooping cough during pregnancy?

Antibiotic therapy against B. pertussis consists of a macrolide antibiotic, such as azithromycin, erythromycin, or clarithromycin. There is some concern about clarithromycin in pregnancy based on showing harmful effects in the fetus in laboratory animals, and little is known about the pregnancy risk of a newer macrolide called fidaxomicin. Thus, azithromycin and erythromycin are the best choices. Although these antibiotics do not moderate the whooping cough attacks or shorten the duration of the disease, they do stop the B. pertussis from spreading through the body, and they also prevent secondary infections.

Who should NOT stop taking medication for whooping cough during pregnancy?

You should not stop or alter your antibiotic treatment without consulting with your physician.

What should I know about choosing a medication for my whooping cough 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 whooping cough when I am breastfeeding?

Some controversy surrounds the use of macrolides in nursing mothers based on a concern that macrolides, especially azithromycin, might cause pyloric stenosis in the infant, a gastrointestinal complication that causes severe vomiting. However, generally, these drugs are considered safe since only tiny amounts enter breastmilk.

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

Generally, the worst cases of pertussis occur in infants, unvaccinated children, and the elderly. The main treatment strategy for pertussis is supportive treatment. This means that you are monitored and given fluids if needed. You may also be given oxygen if needed, and if the condition is very severe, you may be admitted to the intensive care unit. It cannot be overemphasized that the best alternative to medications is to avoid getting whooping cough in the first place by keeping your Tdap boosters up to date, which protects not only you but also your baby.

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

Follow the instructions of your physician, get rest, drink fluids, and eat small meals to reduce the risk that you might vomit during or after paroxysmal coughing. The best thing that you can do for you and your baby, however, is to be vaccinated and keep your boosters up to date.

Resources for whooping cough in pregnancy:

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

Read the whole report
General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.

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