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Pertussis immunization during pregnancy is generally safe and effective.
Pertussis, or whooping cough, is a bacterial respiratory illness caused by the bacterium Bordetella pertussis. Despite widespread vaccination programs, the incidence of whooping cough has risen sharply in adolescents and adults since the 1990s. According to the Centers for Disease Control and Prevention, no deaths due to pertussis have been reported in pregnant women and the disease is not more severe during pregnancy. Women who have whooping cough at the time of delivery may transmit the illness to their babies.
Sudden, violent coughing episodes are the classic symptom of pertussis. These coughing spells are characterized by bouts of rapid, forceful coughing followed by a hurried, deep inhalation -- the "whoop" that is the hallmark of the disease. Not all adults who have the disease have the whoop, but prolonged and repeated coughing is the norm.
Coughing during pregnancy may trigger urinary incontinence and some people with whooping cough sustain rib fractures. These problems can cause embarrassment or discomfort, but they are not usually dangerous. Although forceful coughing is sometimes implicated as the cause of premature labor in pregnant women, there is no evidence whooping cough triggers premature labor or contributes to any other obstetrical complications.
Little Evidence of Fetal Complications
According to a 2011 review in "The Journal of the American Osteopathic Association," only 2 cases of fetal complications have been reported in pregnant women with pertussis. One fetus developed bleeding around the brain and another had an obstructed airway, but in neither case could these abnormalities be directly attributed to the mothers' whooping cough. The greatest risk to babies appears to be catching whooping cough from infected mothers following delivery.
Babies younger than 12 months are at increased risk for complications and death due to whooping cough. In 2009, 12 of 14 pertussis-related deaths reported in the U.S. occurred in infants younger than 6 months old. Most infant deaths due to whooping cough are caused by pneumonia and brain injury. Severe coughing in infants can lead to bleeding into the brain, which may cause seizures, learning disabilities or other long-term complications. In addition, the bacteria that causes whooping cough produces a toxin that can injure the brain. Temporary immunity passed from vaccinated mothers protects infants from whooping cough for approximately 6 months.
Vaccination against pertussis does not provide lifelong immunity. Waning immunity among teens and adults may account for the increase in whooping cough in the U.S. In an effort to blunt this trend and protect infants from infection, the Advisory Committee on Immunization Practices recommended in 2011 that pregnant women be vaccinated against pertussis in the late second or third trimester. If they haven't been vaccinated before or during pregnancy, women should be immunized as soon as possible following delivery.
Immunization is the most effective way to prevent whooping cough and its complications. Your doctor will help you choose the best vaccination schedule for you.