Sore Throat During Pregnancy: Causes & Treatment

Key takeaways:

• During pregnancy, your immune system isn’t as powerful as it is when you’re not pregnant.
• When you’re pregnant, you can catch common infections like pharyngitis (sore throat) from respiratory viruses and bacteria.
• The treatment for pharyngitis during pregnancy is typically the same as treatment for non-pregnant individuals.

Pregnancy is a miraculous and complex process. Being pregnant fine-tunes your system to allow a baby to grow and be delivered nine months later. However, alterations in your immune system may make common infections more likely, such as sore throat (pharyngitis). This may cause you to worry that it could affect your baby – which is a natural reaction. This article covers what you need to know about having a sore throat during pregnancy, including some of the most common questions.

Common causes of a sore throat during pregnancy

Research has clearly shown that during pregnancy, it’s harder for the immune system to fight off infection. Research has shown that the hormones estrogen and progesterone play a role in lowered immunity during pregnancy – but it’s unknown exactly what that role is. The exact cause of a sore throat can be challenging to pinpoint because many different pathogens (germs) could be involved. These include bacteria, viruses, and even stones (because the tonsils can make stones).

Adding to the confusion, several different types of bacteria and viruses may cause a sore throat during pregnancy. How sick you feel, and how long the infection lasts, depends on the type of bacteria or virus. By far the most common causes of sore throat in pregnancy are :

• respiratory viruses (25–45 percent) and
• a type of bacteria called Group A Streptococcus pyogenes, or GAS (5–15 percent).

GAS infection is more common in pregnancy. While not a major cause of a sore throat, Group B strep is more common in pregnancy than Group A, but mainly in the vagina and urinary tract. Thus, it can infect the newborn at delivery (see below).

While a sore throat can occur in any trimester of pregnancy, following are some time-related conditions that are important to know.

In the first trimester

The most common cause of sore throat during the first 12 weeks of pregnancy is influenza (influenza virus A and B). This early phase of pregnancy is the riskiest time for a developing baby. So, catching influenza can be especially dangerous. It can raise the risk of miscarriage. It can also cause abnormalities in a fetus’s developing central nervous system or heart. Although these situations are rare, they do happen – and getting a flu shot is your best protection from such devastating complications. (Flu shots are safe in any trimester.)

COVID-19 is another viral illness with sore throat as a symptom. Although anyone can become infected with the coronavirus, pregnancy can make its complications worse.

In the second trimester

There are no sore throat concerns exclusive to the second trimester. There is, however, considerable overlap between the first and third trimesters. In other words, anything that can happen in one trimester can happen in all trimesters.

In the third trimester

Group B strep (GBS): If this infection were to become invasive, can be life-threatening. GBS is more common than Group A in pregnancy, but it affects the vagina and urinary tract. As a result, it is a source of infection for the baby in a vaginal delivery. It is included here because pharyngitis caused by GBS is not impossible.

GERD (gastroesophageal reflux). The third trimester is when the baby crowds the most. Your stomach is pushed up, and this alters the separation between stomach acid and your throat. When stomach acid gets in the throat, it can make your throat raw and sore.

During delivery

Late in pregnancy, all women are tested for strep, specifically GBS. If you’re tested and evidence of the infection is found, you’ll be treated with antibiotics during labor. This can help keep your baby from getting infected by exposure to your vagina (and cervix), where the infection resides.

After delivery

Research has shown that postpartum women (those whose babies have been born) have 20 times the risk of a Group A or B strep infection. These infections are not necessarily worse in postpartum women, but they are much more common than among nonpregnant women.

Other causes of sore throat during pregnancy

These causes are the same as those of the general (nonpregnant) population:

• Common colds, measles, chickenpox, croup
• Allergic rhinitis (commonly known as hay fever)
• Dry air (environmental heating dehumidifies air)
• Second-hand smoke (can irritate a nonsmoker’s throat)
• Mononucleosis (known as mono; a viral infection causing pharyngitis)
• Vocal strain (ask any singer!)
• Gonorrhea (the gonococcus bacteria can infect many tissues, including the throat)
• Globus (a harmless, temporary symptom that feels like there’s a lump in the throat)
• Cancer of the throat

Can a sore throat impact the pregnancy or baby?

Not directly. But the respiratory viruses that cause pharyngitis increase the risk of miscarriage. Also, the influenza A or B virus may cause congenital anomalies (birth defects). In any trimester, COVID-19 can make you more prone to blood clots.

Pregnancy-safe at-home remedies to relieve a sore throat

Most cases of sore throat are self-resolving and brief. Treating the symptoms is the best management, whether or not you’re taking prescribed antibiotics.

Rest

Adequate rest allows your body to heal. Getting ample amounts of rest can refresh you physically as well as psychologically.

Hydration

Fluids help your healing processes work better and faster, and reduce fever. Along with drinking plenty of fluids, running humidifiers can help keep you hydrated. Staying hydrated can help keep your throat from getting dried out and sore.

Don’t smoke

Smoking is additionally irritating to your throat, which is already inflamed. Nicotine also narrows blood vessels, which can delay healing.

Gargle

Using salt water to gargle will drive fluids out of your swollen tissues and help relieve a sore throat.

Alternative products

Slippery elm, licorice root, and marshmallow root lozenges are all natural remedies for sore throat, and are safe to use during pregnancy.

Other treatment options for a sore throat during pregnancy

As stated earlier, sore throats (including during pregnancy) may be caused by viruses or bacteria. A sore throat caused by a virus typically lasts under a week and usually requires no medical treatment (antibiotics don't treat viral infections). If the infection is bacterial, antibiotics will likely be prescribed.

Antivirals

Antiviral medications have not been proven to significantly speed up the clearing of pharyngitis before it self-resolves.

Antibiotics

When prescribed for a sore throat caused by bacterial infection, the most powerful antibiotics aren’t needed. Rather, broad-spectrum antibiotics (such as penicillin) can be very effective. One type of antibiotic that is not prescribed during pregnancy is tetracycline. These medications can affect the baby’s bones and teeth.

When to seek medical attention for a sore throat while pregnant

Even though pharyngitis is common, do not hesitate to seek medical attention if you’re concerned.

You should see a doctor if you have:

• Fever
• Earache
• Trouble breathing
• Trouble swallowing
• Excessive drooling

You should go to the emergency room if you have:

• Fever of > 101º F.
• Trouble breathing
• Trouble swallowing
• Excessive drooling

Questions to ask your medical provider about a sore throat during pregnancy

• Do I have strep throat?
• Should I be taking any medications like antibiotics?
• Are there any antibiotics I shouldn’t take?

Frequently asked questions: sore throat and pregnancy

If you’re pregnant and suffering from a sore throat, you may have many questions. These are some of the most typical questions medical providers are asked about sore throat during pregnancy.

Is a sore throat a common sign of pregnancy?

No, it is not a sign of pregnancy.

What if you’re early in your pregnancy and experiencing a sore throat and swollen glands?

See your provider that day. Sore throat and swollen glands indicate involvement with lymph nodes, which is considered serious until proven otherwise.

Managing a sore throat during pregnancy

Pharyngitis is generally considered a minor concern during pregnancy. The real value in seeking care is to ensure a sore throat isn’t due to a bacterial infection, which can affect your or your baby’s health. Otherwise, viral sore throats can come and go without worry. Even though the risk of viruses affecting your baby isn’t zero, it is not much more than that.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

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