Is Bronchitis Dangerous During Pregnancy?

Bronchitis during pregnancy can be concerning, yet it typically does not harm the fetus. Prompt communication with your healthcare provider can help manage symptoms and prevent potential complications, such as pneumonia or acute respiratory distress syndrome.

Identifying Signs of Bronchitis When Pregnant

Bronchitis usually starts with a viral infection. Symptoms include:

• Coughing
• Mucus that may be clear, yellow, or green
• Sore throat
• Chest congestion
• Fever and chills
• Body aches

Contact your healthcare provider if you experience any of the following:

Causes of Bronchitis During Pregnancy

About 90% of bronchitis cases start with a viral infection, although bacterial bronchitis can occur.  

Viruses that might cause bronchitis during pregnancy include:

• Human rhinoviruses
• Influenza virus
• Respiratory syncytial virus
• SARS-CoV-2, the virus that causes COVID-19

Exposure to environmental irritants like cigarette smoke and chemical fumes can lead to bronchitis. Conditions like gastroesophageal reflux disease (GERD) and asthma can also increase your risk.

What’s the Risk of Bronchitis Complications?

Bronchitis usually resolves on its own, but pregnant people may face rare complications like pneumonia, miscarriage, or premature labor.

Pneumonia

During pregnancy, the immune system balances tolerating the fetus and fighting infections. Viral infections can disrupt this balance, affecting inflammation and immune cells.

Secondary bacterial pneumonia is a common complication, occurring in fewer than one out of every one thousand pregnancies.

Not everyone faces the same risk. Pneumonia is more likely when:

• When people become ill with viral infections during the fall and winter months
• When they have underlying conditions (such as asthma)

Anyone can develop pneumonia from bronchitis, so it’s important to be aware, though not overly worried. Early diagnosis usually means it’s treatable during pregnancy.

Acute Respiratory Distress Syndrome (ARDS)

Influenza and COVID-19 can cause bronchitis and, in pregnant people, may lead to acute respiratory distress syndrome (ARDS).

ARDS in pregnancy is rare but can be serious, especially later in pregnancy.

In severe influenza seasons, ARDS risk is twice as high in pregnant people than in other females. Studies suggest the higher risk occurs mostly in those with other health issues.

Premature Labor or Pregnancy Loss

Viral infections can increase the risk of premature labor or delivery, often due to secondary infections. Viral infections and bacterial secondary infections can be problematic due to:

• A drop in the parent’s oxygen (hypoxia) can lead to less oxygen for the fetus.
• Secondary bacterial infections can increase premature labor risk.

Hypoxia or bacterial effects may also raise miscarriage risk, though it’s not often studied separately.

Congenital Infections

Viruses that cause bronchitis rarely lead to congenital infections or birth defects, but some viruses like herpes simplex can.

When to Call Your Healthcare Provider

It’s important to call your healthcare provider if you have any concerns at all about your health, but there are some symptoms that should prompt you to call your practitioner right away:

• Symptoms that are persistent: If you continue to have symptoms for more than two weeks, and especially after three weeks, it’s important to contact your healthcare provider.
• Symptoms that improve and worsen again: If you feel you are getting better and then your symptoms worsen again, you could have a secondary bacterial infection.
• High temperature: A low-grade fever is common with bronchitis, but a fever greater than 101 degrees F may be a sign of a secondary infection.
• Wheezing: Slight wheezing is common with bronchitis, but loud or persistent wheezing suggests airway obstruction (reactive airway disease).
• Shortness of breath: Many women feel mild shortness of breath due to pregnancy, but if you notice the sudden onset or worsening of symptoms, you should contact your healthcare provider.
• Rapid respiratory rate: While some shortness of breath can be normal in pregnancy, the rate of your breathing (respiratory rate) should remain the same (respiratory rate does not change in pregnancy, but volume of air taken with each breath is mildly increased). If you notice you are breathing faster than usual (tachypnea) or if your breathing is shallow, talk to your healthcare provider right away.
• Coughing up blood: Coughing up blood, even a trace, is a reason to contact your practitioner right away.
• Chest pain/tightness: A feeling of chest tightness is common with pneumonia. While coughing can cause some discomfort, it’s best to talk to your healthcare provider.
• Lightheadedness: If you feel lightheaded or faint, it could be a sign that you aren’t getting enough oxygen.
• Decreased fetal movement: If your baby seems to be moving less often than usual, call your practitioner.

Pregnancy-Safe Treatments for Bronchitis

Generally, bronchitis will clear up on its own in time, though if it is due to a bacterial infection (or if you develop a secondary infection), antibiotics may be needed.

Most of the time, home remedies will control your symptoms while the illness runs its course.

Prescription Medication

If you feel you need a cough or cold preparation, call your obstetrician to learn about their recommendations. It’s important to remember that many medications are not safe to use during pregnancy.

If your healthcare provider determines that you have a bacterial infection, they may prescribe antibiotics. Antibiotics that are considered safe during pregnancy include:

• Amoxil (amoxicillin)
• Ampicillin
• Zithromax (azithromycin)
• Cleocin (clindamycin)
• Macrobid (nitrofurantoin)
• Penicillin
• Firvanq (vancomycin)

Natural Remedies

Some natural remedies and comfort care you can try if you have bronchitis include:

• Rest: Getting plenty of rest will give your body a chance to recover. Don’t be afraid to ask for help if you need it.
• Drinking enough fluids: Fluid requirements increase during pregnancy. Having an infection can further increase your water needs, and being dehydrated may increase your risk for kidney infections. Try to drink between 64 and 96 ounces or 8 to 12 cups of water daily.
• A cold air humidifier: A humidifier can help with congestion, but make sure it is cleaned properly before use. You should also avoid adding anything (such as Vicks) to the water.
• Honey: A 2021 review of studies found that honey actually worked better than over-the-counter cough suppressants and other remedies to control the frequency and severity of coughing.
• Warm tea: Warm liquids can be soothing if your throat is sore from coughing. Adding a little honey and lemon may actually help reduce your cough.
• Using medications sparingly: Tylenol (acetaminophen) and some cough and cold medications can be taken safely during pregnancy, but use them only as needed. A low-grade fever, as long as you’re not uncomfortable, actually helps fight infections.
• Saline nasal flush: Some people find that a saline flush can help with nasal congestion, and Neti Pots are now available at most pharmacies. A caveat is that it’s important to only use sterile saline to avoid the rare risk of serious infection.

Tips to Limit Your Bronchitis Risk While Pregnant

Although you may not be able to prevent bronchitis entirely, there are a number of ways that you can reduce your risk. These include:

• Avoiding friends or family members who are ill
• Avoiding crowded events, especially during cold and flu season
• Frequent handwashing, or using hand sanitizer when needed
• Avoiding cigarette smoke
• Wearing a mask if you will be exposed to dust/fumes (such as wood dust) or if you may be around people who have cold and flu symptoms
• Minimizing outdoor activity if the air pollution level in your area is high (traffic-related air pollution is an important risk factor for bronchitis during cold season)

Vaccination

Getting your annual flu shot and making sure you’re fully vaccinated against COVID-19 are also important. In addition, women who develop symptoms of influenza or COVID-19 should contact their healthcare provider.

Getting vaccinated not only helps you, but can also help your developing baby. Antibodies are passed from a mother to infant both through the placenta and via breast milk (in those who are nursing), and can protect babies until 6 months of age when they become eligible for vaccination.

For people ages 19 to 64 who smoke or have certain medical conditions, the pneumonia vaccine (in this case, PPSV 23) may be recommended. Make sure your obstetrician is aware of your past medical history. Even though women who are pregnant may be hesitant to tell their healthcare provider that they smoke, speak up honestly, as the pneumonia vaccine is recommended for anyone who smokes.

Control of Coexisting Conditions

If you have other medical conditions, such as asthma, that can lead to complications of viral infections, make sure these conditions are controlled as well as possible during pregnancy, as they can increase the risk of complications from viral infections.