According to the Centers for Disease Control and Prevention (CDC), the H1N1 flu has hit pregnant women especially hard. About 700 cases have been confirmed in pregnant women since late April, about 100 pregnant women have required admission to intensive care units, and 28 pregnant women have died from the H1N1 flu, the CDC reported earlier this month.

“Because pregnant women who get influenza have a greater chance for serious complications, it is important they receive both the 2009 H1N1 flu shot and the seasonal flu shot.  Receiving these vaccines is the best way pregnant women can protect themselves – and their newborns – against the flu,” said Rosalie Pepe, M.D., infectious disease specialist at Cooper University Hospital.

Research has found that women who get a flu shot during pregnancy get sick with the flu less often than pregnant women who do not get a flu shot. The same holds true for their newborns. Babies born to mothers who get a flu shot during pregnancy get sick with the flu less often than babies born to mothers who did not get a flu shot during pregnancy.

A woman can receive both the seasonal flu shot and the H1N1 flu shot at any time during pregnancy. But, pregnant women should get the vaccines by injection – a “flu shot” – not by nasal spray. The nasal spray vaccine is not approved for pregnant women.

The injectable vaccine is made with inactivated flu virus. It is given with a needle, usually in the arm. The nasal spray vaccine is made with live, weakened flu virus and should be used only in healthy people ages 2 to 49 years old, and women who are not pregnant.

Following delivery, new mothers can safely get either the injectable or nasal spray vaccine, even if they are breastfeeding. In fact, vaccinated mothers who are nursing can pass on vaccine antibodies to their infants and reduce their babies’ chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies because they are too young to be vaccinated.

Dr. Pepe reminds pregnant women to get both a seasonal flu shot and a H1N1 flu shot as early as possible.

“You will need both shots this year to fully protect yourself and your baby against the flu. Both shots are absolutely safe and recommended for pregnant women and nursing mothers,” she said.

Additional H1N1 Flu Resources from Cooper University Hospital

• H1N1 Influenza and Seasonal Flu Information and Resources – Cooperhealth.org
  Visit our H1N1 resource page for information to help you and your family prepare for this year’s flu season. We will be updating this page as new information becomes available.
• Health eTalk Web Chat: Your Questions about H1N1 Pandemic Flu – Cooperhealth.org/etalk
  Join Rosalie Pepe, M.D., of Cooper University Hospital’s Division of Infectious Diseases, as she answers your questions live on Cooperhealth.org.  No question is too big or too small, as she’ll help you sort through the rumors and debunk the myths.

Chronic health conditions such as diabetes, high blood pressure or asthma can place an expectant mother in the high-risk group. Other causes, such as carrying more than one fetus, previous complicated pregnancy, birth defects, preterm labor, or developing a condition during pregnancy, such as gestational diabetes, also can warrant a high-risk classification.

“While obstetricians can handle many pregnancy complications that arise, some require the expertise of a high-risk specialist during pregnancy. These are the women who may benefit from seeing a maternal-fetal medicine physician,” said Richard L. Fischer, M.D., Head of the Division of Maternal-Fetal Medicine at Cooper.

Also called perinatologists, maternal-fetal medicine physicians are obstetricians/gynecologists who specialize in high-risk conditions of both women and their unborn babies. These specialists complete two to three years of additional medical training and clinical experience. They concentrate on the obstetrical, medical, genetic and surgical complications that can arise in pregnancy, and their effects on both the mother and the fetus. They also have unique expertise in performing obstetrical ultrasounds, which can lead to an improved detection of many types of fetal birth defects in otherwise low-risk pregnancies.

Due to the high level of maternal-fetal and neonatal care offered at Cooper, the state of New Jersey has designated Cooper University Hospital as a Regional Perinatal Center.  Cooper’s Maternal-Fetal Medicine Program includes a team of eight specialized physicians providing comprehensive services at seven different locations throughout Atlantic, Burlington, Camden, Cape May and Mercer counties.

Some of the high-level services available at Cooper include high-resolution ultrasounds; combined first- and second-trimester Down syndrome screening; fetal echocardiography; perinatal and genetic counseling during pregnancy; procedures such as chorionic villus sampling (CVS) and amniocentesis; and pre-pregnancy consultations with maternal-fetal medicine specialists.

Cooper maternal-fetal medicine specialists work closely with obstetricians to develop individualized care-plans for patients.  A patient may see a maternal-fetal medicine specialist several times during her pregnancy, but the obstetrician will continue to manage the pregnancy and deliver the baby (in most cases).

For newborns with special needs, Cooper also offers the highest level of neonatal intensive care in its Neonatal Intensive Care Unit (NICU). The unit is distinguished as one of only two NICU’s in the world to be certified as a NIDCAP nursery.

NIDCAP, or Newborn Individualized Developmental Care and Assessment Program, is a multi-disciplinary model that supports the growth and development of premature infants through a relationship-based approach to care, for both the infants and their families.  “Preemies are living, breathing human beings who can tell whether they like or dislike what we’re doing to them. And not only can we read the signs, but we can teach parents how to read the signs, too,” said Gary E. Stahl, M.D., Head of Neonatal Services at Cooper.

Dr. Fischer adds, “Obstetrical patients at Cooper can have peace of mind knowing that if there are complications with their pregnancy, during childbirth, or with their newborn babies, they will have access to the most highly-skilled team of specialists in southern New Jersey.”