I have found that writing a review paper is a frustrating thing. I was hoping to find more evidence that clearly supports or discourages the use of Tamiflu during pregnancy. Thus far, the literature has not shown fetal impairments at a rate that is different from the normal population. I would like to be able to find information in retrospective studies that compares the outcomes of using Tamiflu in women that had a confirmed influenza test and ones that were treated prophylactically but never tested positive for influenza. This could help to determine if the complications that occurred were due to the medication or the viral infection.
The current studies that I have found allow me to compare women who were given Tamiflu verses those who were not given Tamiflu during the H1N1 outbreak in 2009. One of the large problems with comparing the H1N1 pandemic with other yearly influenza outbreaks is that the H1N1 strain was particularly aggressive. By definition, pregnancy category C medications have to be evaluated for risks vs benefit by a health care professional. To compare the H1N1 outcomes with other influenza outbreaks, you have to remember that the risks verses benefit may be different. It may have been more beneficial to give a mother Tamiflu in the case of H1N1 due to the high risks associated with the infection. However, use in women with a less virulent strain may not attain as great of benefit from the use of Tamiflu.