Cold or Flu During Pregnancy and Miscarriage

Hispanic woman wiping nose with tissue
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Winter is cold season, and it can be hard to avoid catching a virus during those months. Should you be especially worried about common winter viruses if you're pregnant? Could a cold, flu, or COVID-19 cause harm to a baby or trigger a miscarriage? Find out more below. 

Miscarriage Risk

Although cold and flu viruses can certainly make you uncomfortable (especially if you're pregnant and certain medications are off-limits), they aren't likely to cause miscarriage.

During the 1918 flu pandemic, the influenza virus clearly played a role in miscarriages. It's thought that one in 10 pregnant women had early miscarriages during that time, over and above what would be considered the expected incidence.

A century later, a review of 100 studies of influenza in pregnancy found that especially when pregnant women developed complications from influenza, they were at risk for miscarriage, stillbirth, and preterm birth.

Having a fever during pregnancy (a temperature that's higher than 100 degrees Fahrenheit) is linked with an increased miscarriage risk. If you do catch the flu or COVID-19, your doctor may advise you to keep your fever controlled with Tylenol (acetaminophen) while you are sick.

Remember: Always ask your doctor before taking any over-the-counter pill while you're pregnant because many—like Sudafed (pseudoephedrine), Dayquil (acetaminophen, dextromethorphan, phenylephrine), Aleve (naproxen), Advil (ibuprofen), Motrin (ibuprofen), Bayer (aspirin), and Excedrin (aspirin, paracetamol, caffeine)—are not considered safe.

It's important to note that the flu does carry other concerns for people who are pregnant. During the 2009 H1N1 flu (swine flu) pandemic, for example, people who contracted the flu while pregnant had an increased risk of preterm delivery (having the baby before 37 weeks), infant death, and intensive care unit admissions.

According to the Centers for Disease Control and Prevention (CDC), pregnant people with COVID-19 are also at higher risk of preterm delivery. While higher rates of pregnancy loss are suspected, there is no definitive data on miscarriage risk and COVID-19.

Flu Vaccine

The flu vaccination has been studied extensively and does not appear to pose any risk with regard to miscarriage. Both the CDC and the American College of Obstetricians and Gynecologists recommend the flu vaccine for all pregnant people at any point in pregnancy.

The vaccine protects not only pregnant people but also their babies, who are born with some protection against flu viruses.

COVID-19 Vaccine

Data collected by the CDC and the U.S. Food and Drug Administration regarding the COVID vaccine "did not identify any safety concerns for pregnant people who were vaccinated or for their babies."

Animal studies have also not revealed any adverse outcomes in pregnant animals or their offspring. Based on this evidence, the CDC recommends that pregnant people receive the COVID-19 vaccine to help protect against infection and possible severe illness.

Symptoms

A cold, the flu, and COVID-19 can all cause similar symptoms even though they're triggered by different viruses. Symptoms may include fever, fatigue, body aches, and dry cough.

With a cold, a person is more likely to have rhinorrhea (a stuffy and runny nose). Furthermore, colds usually don't have the potential to lead to more serious problems that would result in hospitalization, such as pneumonia or more severe bacterial infections.

With the flu or COVID-19, symptoms may hit suddenly and are typically more severe than those of a cold. Based on your symptoms alone, your physician may have trouble distinguishing a cold from the flu or COVID-19 because they're so similar. However, tests can be done to distinguish among them and determine the appropriate treatment.

Risk Factors

Although anyone can catch a virus, viral infections are more common among the following populations:

  • People who are pregnant
  • Older people
  • Children
  • People with chronic medical conditions, such as asthma or heart disease

Complications

Fortunately, most people who get the flu recover after a few days. However, some people do develop pneumonia, a serious lung infection that can sometimes be deadly. Other respiratory infections can also result from the flu, including bronchitis and sinusitis.

The flu also can result in an ear infection (the middle ear is connected to the respiratory tract) and exacerbate other illnesses.

For example, the flu can make asthma worse and serve as a trigger for asthma attacks. Additionally, the flu can make heart failure worse.

The CDC has found that pregnant people with COVID-19 are at increased risk of severe illness. This may result in hospital admission requiring intensive care treatment and/or the use of a ventilator to help with breathing.

Prevention

There are some key steps that you can take to lower your risk of contracting a viral infection. In addition to getting vaccinated, avoid close contact with people who are sick, wash your hands frequently for at least 20 seconds, avoid touching your eyes, nose, and mouth, and disinfect things that you touch a lot (like your phone, your computer, doorknobs and light switches, and so on).

Of course, general health habits like getting enough sleep, eating nutritious foods, being active, managing stress, and staying hydrated can all boost your immune system and help you fend off disease.

10 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Doyle TJ, Goodin K, Hamilton J. Maternal and neonatal outcomes among pregnant women with 2009 pandemic influenza A(H1N1) illness in Florida, 2009-2010: a population-based cohort study. PLoS ONE. 2013;8(10):e79040. doi:10.1371/journal.pone.0079040

  5. Centers for Disease Control and Prevention. Pregnant and recently pregnant people.

  6. McMillan M, Porritt K, Kralik D, Costi L, Marshall H. Influenza vaccination during pregnancy: a systematic review of fetal death, spontaneous abortion, and congenital malformation safety outcomes. Vaccine. 2015;33(18):2108-17. doi:10.1016/j.vaccine.2015.02.068

  7. Centers for Disease Control and Prevention. COVID-19 vaccines while pregnant or breastfeeding.

  8. Centers for Disease Control and Prevention. People at high risk for flu complications.

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  10. Centers for Disease Control and Prevention. Pregnant women and influenza (flu).

Additional Reading

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.