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Peer-reviewedCC BYDiagnostics (Basel, Switzerland)

Influenza in Pregnancy: From the Maternal Lung to the Placenta and Fetus.

  • Radu Vlădăreanu1,2
  • Andreea Borislavschi1,2
  • Emanuel Moisă3,4
  • Mihaela Boț1,2
4 affiliations
  1. 1Department of Obstetrics and Gynaecology, Elias Emergency University Hospital, 17 Mărăști Boulevard, 011461 Bucharest, Romania.
  2. 2Department of Obstetrics, Gynecology and Neonatology, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania.
  3. 3Department of Anesthesiology and Intensive Care, Elias Emergency University Hospital, 17 Mărăști Boulevard, 011461 Bucharest, Romania.
  4. 4Department of Anesthesiology and Intensive Care, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania.
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Abstract

Influenza in pregnancy is associated with a higher risk of severe respiratory disease and adverse maternal and perinatal outcomes, particularly later in gestation. This narrative review synthesizes evidence on epidemiology, pathophysiology, placental and fetal consequences, clinical presentation, diagnosis, antiviral management, and vaccination. Pregnancy involves dynamic immune adaptation together with reduced respiratory reserve, increased oxygen consumption, and cardiovascular changes that may amplify the effects of influenza pneumonia. Placental and fetal consequences appear to be mediated predominantly by maternal hypoxemia, fever, systemic inflammation, and hemodynamic disturbance; transplacental viral transmission is rare. Therefore, adverse fetal and neonatal outcomes are more closely linked to the severity and timing of maternal illness, placental dysfunction, and prematurity than to direct fetal infection. Prompt recognition is essential, and antiviral treatment should not await laboratory confirmation when influenza is suspected. Oseltamivir remains the preferred antiviral therapy and should be initiated as early as possible, including in patients presenting after 48 h with progressive or severe disease. Seasonal inactivated or recombinant influenza vaccination is the cornerstone of prevention, protecting both the mother and the infant through transplacental transfer of influenza-specific IgG. This integrated perspective supports vaccination, early diagnosis, and timely treatment to reduce maternal and perinatal risk.

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Cite

BibTeXRIS
BibTeX
@article{vladareanu2026influenza,
  title = {{Influenza in Pregnancy: From the Maternal Lung to the Placenta and Fetus.}},
  author = {Radu Vlădăreanu and Andreea Borislavschi and Emanuel Moisă and Mihaela Boț},
  journal = {Diagnostics (Basel, Switzerland)},
  year = {2026},
  month = oct,
  doi = {10.3390/diagnostics16193250},
  url = {https://europepmc.org/article/MED/42882405},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Influenza in Pregnancy: From the Maternal Lung to the Placenta and Fetus.
AU  - Radu Vlădăreanu
AU  - Andreea Borislavschi
AU  - Emanuel Moisă
AU  - Mihaela Boț
PY  - 2026
DA  - 2026/10/08
JO  - Diagnostics (Basel, Switzerland)
DO  - 10.3390/diagnostics16193250
UR  - https://europepmc.org/article/MED/42882405
AB  - Influenza in pregnancy is associated with a higher risk of severe respiratory disease and adverse maternal and perinatal outcomes, particularly later in gestation. This narrative review synthesizes evidence on epidemiology, pathophysiology, placental and fetal consequences, clinical presentation, diagnosis, antiviral management, and vaccination. Pregnancy involves dynamic immune adaptation together with reduced respiratory reserve, increased oxygen consumption, and cardiovascular changes that may amplify the effects of influenza pneumonia. Placental and fetal consequences appear to be mediated predominantly by maternal hypoxemia, fever, systemic inflammation, and hemodynamic disturbance; transplacental viral transmission is rare. Therefore, adverse fetal and neonatal outcomes are more closely linked to the severity and timing of maternal illness, placental dysfunction, and prematurity than to direct fetal infection. Prompt recognition is essential, and antiviral treatment should not await laboratory confirmation when influenza is suspected. Oseltamivir remains the preferred antiviral therapy and should be initiated as early as possible, including in patients presenting after 48 h with progressive or severe disease. Seasonal inactivated or recombinant influenza vaccination is the cornerstone of prevention, protecting both the mother and the infant through transplacental transfer of influenza-specific IgG. This integrated perspective supports vaccination, early diagnosis, and timely treatment to reduce maternal and perinatal risk.
SN  - 2075-4418
ER  -