A temperature of 100.4°F (38°C) or higher is generally defined as a fever, and this elevation in body temperature requires immediate attention during pregnancy. While a fever is a common response to infection, the body’s internal heat itself, known as hyperthermia, can pose potential risks to the developing baby. This article provides general information and should not replace the specific medical advice of your obstetrician or other healthcare provider.
The Importance of Prompt Treatment
The primary concern with fever in pregnancy is the elevated core body temperature, especially if it is sustained or particularly high. Hyperthermia has been associated with potential developmental issues, most notably if it occurs during the first trimester of pregnancy. Studies have suggested a possible link between high fevers in early pregnancy and an increased risk of neural tube defects, which are birth defects affecting the brain and spinal cord.
The risk is not necessarily due to the underlying cause of the fever, but to the heat itself interfering with fetal development processes. Untreated fevers may also raise the risk of pregnancy loss or preterm birth. Swift action is recommended to minimize the duration of the elevated temperature and protect the developing fetus.
The Recommended Over-the-Counter Relief
Acetaminophen, often sold under the brand name Tylenol or as Paracetamol, is considered the first-line medication for reducing fever during pregnancy. This medication is generally regarded as safe for use throughout all three trimesters when taken at the lowest effective dose for the shortest necessary duration. It works by acting on the heat-regulating center in the brain to help the body cool down.
A typical adult dose for fever relief involves taking 325 mg to 650 mg every four to six hours as needed. The maximum recommended daily dosage is generally limited to 3,000 mg to 3,250 mg in a 24-hour period. It is crucial to check the labels of any combination cold or flu products, as they often contain acetaminophen and can lead to an accidental overdose if taken alongside a separate acetaminophen product.
Drug-Free Methods for Reducing Body Temperature
Physical measures can support the action of medication or provide comfort while awaiting relief. Adequate hydration is important, as fever increases the risk of dehydration, which can lead to complications such as Braxton Hicks contractions. Drinking plenty of clear fluids, such as water, juice, or broth, helps the body regulate its temperature and prevents fluid loss.
Applying cool compresses to the forehead, neck, or armpits can help draw heat away from the body. A lukewarm bath or shower can be an effective way to lower the core temperature. It is important to use lukewarm water and avoid cold water, which can cause shivering and paradoxically raise the body’s internal temperature. Wearing light, breathable clothing and keeping the surrounding environment cool will also assist in managing the fever.
Medications That Pose a Danger During Pregnancy
Most healthcare providers advise against taking Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve), while pregnant, especially after the first 20 weeks. The use of NSAIDs in the third trimester carries a risk of causing premature closure of the fetal heart’s ductus arteriosus, a blood vessel that is supposed to remain open until after birth. These medications can also reduce the volume of amniotic fluid, a condition known as oligohydramnios, by affecting the baby’s kidneys.
Aspirin, which is also an NSAID, should be avoided for fever and pain relief unless a low-dose regimen is specifically prescribed by a doctor for certain medical conditions, such as preventing preeclampsia. Furthermore, many over-the-counter cold and flu preparations contain decongestants, such as pseudoephedrine or phenylephrine, that can narrow blood vessels. These decongestants are generally restricted during pregnancy, particularly in the first trimester, and should only be used with explicit medical approval.
Symptoms Requiring a Call to Your Doctor
Immediate medical consultation is necessary if a fever reaches 102°F (38.9°C) or higher, as this temperature level increases the potential for complications. You should also contact your doctor if a fever persists for more than 24 to 48 hours despite taking acetaminophen or using physical cooling methods. This persistence may indicate a more serious underlying infection that requires prescription treatment, such as antibiotics.
Certain accompanying symptoms require prompt professional evaluation regardless of the temperature reading:
- Severe headache, stiff neck, rash, confusion, or difficulty breathing.
- Signs of dehydration, such as severe thirst or decreased urination.
- Changes in the pregnancy, such as decreased fetal movement or severe abdominal pain.