Rhinovirus, the most common cause of the common cold, is not considered dangerous for most pregnant people. It does not cross the placenta to infect the fetus, and a straightforward cold will typically resolve on its own within 7 to 10 days without harming your pregnancy. The real concerns are indirect: fever that climbs too high, asthma flare-ups, and the limited medication options available during pregnancy. Understanding these risks puts you in a much better position to manage a cold safely.
Why Rhinovirus Itself Isn’t the Main Concern
Rhinovirus infects the upper respiratory tract, your nose and throat, and stays there. Unlike some infections that can reach the fetus (such as cytomegalovirus or Zika), rhinovirus doesn’t enter the bloodstream in a way that threatens fetal development. The virus causes familiar symptoms: congestion, sneezing, sore throat, mild cough, and sometimes a low-grade fever. For a healthy pregnant person, the infection follows the same course it would at any other time in your life.
That said, pregnancy changes your immune system. Your body dials down certain immune responses to avoid rejecting the pregnancy, which can make cold symptoms feel worse or last a bit longer than usual. You may also feel more fatigued, and congestion can be more pronounced because pregnancy hormones already cause nasal swelling on their own.
The Fever Risk That Actually Matters
The most concrete danger from any cold-causing virus during pregnancy is a sustained high fever. A maternal core temperature reaching or exceeding 39.0°C (about 102.2°F) has been identified as the critical threshold for increasing the risk of birth defects, particularly neural tube defects like spina bifida. This risk is highest during the first trimester, when the neural tube is forming.
Most rhinovirus infections produce only a mild fever or none at all, so this threshold is rarely an issue with a typical cold. But if your temperature does climb, bringing it down matters. Acetaminophen (Tylenol) remains the recommended option. The American College of Obstetricians and Gynecologists describes it as well studied and proven safe for use in pregnancy, and notes that failing to treat fever during pregnancy can itself create severe risk of harm. The key is using it at standard doses and for the shortest time needed, ideally after checking with your provider.
Rhinovirus and Asthma in Pregnancy
If you have asthma, rhinovirus is a different story. A prospective study of pregnant people with asthma found that rhinovirus was by far the most common virus detected during respiratory infections, accounting for 38.5% of all viruses identified. Among those who tested positive for any respiratory virus, one-third experienced asthma exacerbations severe enough to require medical intervention, and another third lost control of their asthma without reaching the level of a full flare-up.
Uncontrolled asthma during pregnancy is associated with preeclampsia, preterm birth, and low birth weight. So for anyone with asthma, even a “simple” cold demands closer attention. Staying on your prescribed asthma medications throughout pregnancy, keeping a rescue inhaler accessible, and contacting your provider early if you notice increased wheezing or shortness of breath are all important steps. Most asthma medications, including inhaled corticosteroids, are considered safe in pregnancy, and stopping them carries more risk than continuing them.
Safe Ways to Manage Cold Symptoms
Because so many common cold medications are off-limits or questionable during pregnancy, non-drug approaches are your first line of relief. Saline nasal spray is safe to use as often as you need it and helps thin mucus and reduce congestion. Nasal irrigation with a neti pot and a premixed saline solution, done once a day or as needed, is another effective option. Adhesive nasal strips can physically hold your nasal passages open, which is especially helpful at night.
Elevating the head of your bed by 30 to 45 degrees can ease nighttime congestion and help you sleep. Moderate physical activity, even a short walk, helps reduce nasal inflammation. Staying hydrated with water, broth, or warm beverages keeps mucus from thickening.
For medications beyond acetaminophen, your options narrow considerably. Pseudoephedrine (Sudafed) is not recommended during pregnancy because it can reduce blood flow through the placenta. There is also some evidence linking pseudoephedrine use in the first 12 weeks of pregnancy to birth defects, though the evidence is not strong. Phenylephrine, the other common OTC decongestant, carries similar concerns about blood vessel constriction. If congestion is severe enough that you feel you need a decongestant, talk to your provider first.
When a Cold Could Be Something Else
Not every respiratory illness is rhinovirus. Influenza, RSV, and COVID-19 all start with cold-like symptoms but carry higher risks during pregnancy, including pneumonia and preterm labor. A few signs suggest something beyond a common cold: fever above 38.9°C (102°F) that doesn’t respond to acetaminophen, difficulty breathing or chest tightness, symptoms that worsen after initially improving, or illness lasting more than 10 days. Any of these warrants a call to your provider, who can test for flu or other viruses and start treatment if needed. Flu in particular responds well to antiviral medication when caught within the first 48 hours.
Preventing Colds During Pregnancy
Rhinovirus spreads through respiratory droplets and contaminated surfaces, and it’s remarkably efficient at both. Frequent handwashing with soap and water is the single most effective prevention strategy. Avoid touching your face, especially in public spaces. If someone in your household is sick, encourage them to wash their hands often and avoid sharing cups or utensils.
There is no vaccine for rhinovirus. But getting your flu shot and staying up to date on COVID-19 vaccination reduces the chance that a respiratory illness you do catch turns out to be one of the more dangerous viruses. Both vaccines are recommended during pregnancy.