What to Know About Bronchitis During Pregnancy

While people who are pregnant are not truly immunosuppressed, the delicate balance of the immune system during pregnancy can be upset by viral infections, including bronchitis.

Bronchitis Symptoms

Bronchitis often develops along with a viral infection. Symptoms may include:

• A cough that may be dry or productive of sputum. When mucus is present, it may be clear, yellow, or green.
• Sore throat
• Sinus congestion
• A low-grade fever (usually less than 100.5 degrees F) and chills
• Body aches

Less commonly (and sometimes a sign of a complication), you may experience:

• Chest tightness
• Wheezing
• Shortness of breath
• Coughing up blood (even a very small amount is a medical emergency)

Prevention Tips

An ounce of prevention is definitely worth a pound of cure when it comes to contracting bronchitis during pregnancy. 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 (yes, we understand this can be challenging if you have small children)
• 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 is also important, and the Centers for Disease Control and Prevention (CDC) recommends that pregnant people get the flu vaccine (it doesn’t matter which trimester). In addition, women who develop symptoms of influenza should contact their healthcare provider.

Getting your flu vaccine not only helps you, but can help your developing baby. Antibodies are passed from a mother to her 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, this is one reason why speaking up honestly is important, 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, it’s important to make sure these conditions are controlled as well as possible during pregnancy as they can increase the risk of complications from viral infections.

Related Complications

While bronchitis often runs its course in the general population as well as among women who are pregnant, some may develop complications such as severe illness. These complications, though uncommon, can range from pneumonia to problems that affect pregnancy directly such as miscarriage or premature labor.

A number of different viruses that cause bronchitis symptoms may be responsible for bronchitis during pregnancy. Some of these include:

• Human rhinoviruses
• Influenza virus
• Respiratory syncytial virus

Pneumonia

During pregnancy, the immune system operates on a fine balance between tolerating a “foreign” entity (the baby) and remaining competent to fight off infectious organisms such as viruses and bacteria. Viral infections can disrupt this balance by causing changes in inflammation, immune cells, and more.

The most common complication of bronchitis is a secondary bacterial pneumonia, which occurs in roughly 1.5 of every one thousand pregnancies.

Not all women are at the same risk. Pneumonia is more likely to occur:

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

That said, anyone could potentially develop pneumonia as a complication of bronchitis, thus it’s important to be aware (but not unduly worried) about this complication. When diagnosed early, pneumonia during pregnancy is generally treatable.

Acute Respiratory Distress Syndrome (ARDS)

Influenza is an important cause of bronchitis and, in pregnant people, can be a risk factor for acute respiratory distress syndrome (ARDS).

While very uncommon, ARDS due to influenza in pregnant women can be very serious or lead to death. It is much more common in women toward the end of pregnancy and shortly after delivery.

During years in which influenza seasons are particularly bad, the risk of ARDS was found to be twice as high in pregnant women as in women who were not pregnant. This may sound alarming, but studies have looked primarily at years when the influenza rate was very high, and complications were much more likely to occur in those who had underlying risk factors.

Premature Labor or Pregnancy Loss

In addition to pneumonia and other lung issues, viral infections may also increase the risk of premature labor and delivery (often due to the secondary infections that follow the viral infection).

There are a number of reasons why a viral infection (or subsequent bacterial secondary infections) could be a problem. These include:

• The oxygen level in the mother falls (hypoxia), resulting in less oxygen to the fetus.
• Some bacterial infections (that can follow a viral infection) can directly increase the risk of premature labor.

While not looked at separately in many studies, the same principles (hypoxia or direct bacterial effect) could also increase the risk of miscarriage.

Congenital Infections

Though the viral infections that lead to bronchitis are uncommon as far as causes of congenital infections (infections that affect babies and can lead to problems such as birth defects), it’s important to note that some viruses—such as herpes simplex, cytomegalovirus, and others—can be associated with these problems.

When to Call Your Healthcare Provider

Certainly, 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. These include:

• 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.

Treatment

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.

The mainstay of “treatment” most of the time will be home remedies to control your symptoms while the illness runs its course. The caveat is that many pregnant women, especially those who have young children at home, are accustomed to taking care of others rather than themselves. If you are one of those, giving yourself a “prescription” to rest and be pampered may be just what the healthcare provider ordered.

Comfort measures can include:

• Rest: It’s harder to overstate the importance of resting, even if that means a nap in the middle of the day. If you need to lean on family and friends to find the time, don’t hesitate. If you feel you need permission, tell yourself you are doing it for the baby, but please rest.
• Drink enough fluids: Fluid requirements increase during pregnancy, and studies suggest that many women are insufficiently hydrated. Having an infection can further increase your water needs, and being dehydrated may increase your risk for kidney infections. To ensure an adequate daily intake of water (64 to 96 ounces or 8 to 12 cups), some women place a container of water in the fridge containing that amount each morning. Later in pregnancy, some women hesitate to drink more fluids since it means more trips to the restroom while trying to rest. This is another reason to lean on people who have offered to help.
• Try 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.
• Try a teaspoon of honey: While people have used honey for a century to combat cold symptoms, a 2021 review of studies found that evidence backs this old wives’ tale. Honey actually worked better than over-the-counter cough suppressants and other remedies to control the frequency and severity of coughing.
• Sip on a cup of 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.
• Use medications sparingly: While both Tylenol (acetaminophen) and some cough and cold medications can be used safely during pregnancy, use these only as needed. A low-grade fever, as long as you’re not uncomfortable, actually helps fight infections. If you feel you need a cough or cold preparation, call your obstetrician to learn about their recommendations.
• Try a saline nasal flush: Some people find 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.

A Word From Verywell

Coping with bronchitis can be tiring during pregnancy, and hearing about potential complications can be frightening. For the vast majority of people, the infection clears up without problems and is quickly forgotten.

The most important thing to keep in mind if you develop symptoms of bronchitis is to communicate with your obstetrician. Not only can they give you ideas on how to cope with the symptoms and let you know if and when you should be concerned, but they may give you something else that’s priceless when you’re pregnant: the reassurance that you aren’t alone, and that multitudes of people have similarly experienced this speed bump in pregnancy and gone on to forget it even happened as they hold their newborn treasure.