A large new study has found that drugs taken to prevent or treat flu during pregnancy are unlikely to damage the foetus.
Pregnancy raises the usual risks from exposure to the flu virus, so a team led by Dr Sophie Graner at the Karolinska Institutet, Stockholm, Sweden, examined the dangers posed by the antiviral drugs called neuraminidase inhibitors in pregnancy.
They explain that in Europe, where the study took place, oseltamivir, taken orally, and zanamivir, which is inhaled, are the two approved neuraminidase inhibitors.
The number of pregnant women exposed to neuraminidase inhibitors increased markedly following the 2009 H1N1 pandemic.
The team used national registers from Denmark, Norway, Sweden and France, including 5,824 pregnant women who took neuraminidase inhibitors (0.8% of the total number of pregnant women).
Exposure "was not associated with increased risks of any of the investigated neonatal outcomes, including low birth weight, low Apgar score, preterm birth, small for gestational age birth, stillbirth, neonatal mortality, and neonatal morbidity," they report in BMJ today (1 March).
This remained the case once several health-related factors were taken into account, such as age, smoking and use of other medications. There was also no rise in congenital malformations linked to use of these drugs in the first trimester.
The team concludes: "This large multinational register study found no increased risks of adverse neonatal outcomes or congenital malformations associated with exposure to neuraminidase inhibitors during embryo-foetal life.
"The results support previously reported findings that the use of neuraminidase inhibitors is not associated with increased risks of adverse foetal or neonatal outcomes."
Graner, S. et al. Neuraminidase inhibitors during pregnancy and risk of adverse neonatal outcomes and congenital malformations: population based European register study. BMJ 1 March 2017; doi: 10.1136/bmj.j629 [abstract]
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