Travel During Pregnancy: Considerations for the Obstetric Provider

Importance: Travel among US citizens is becoming increasingly common, and travel during pregnancy is also speculated to be increasingly common. During pregnancy, the obstetric provider may be the first or only clinician approached with questions regarding travel. Objective: In this review, we discuss the reasons women travel during pregnancy, medical considerations for long-haul air travel, destination-specific medical complications, and precautions for pregnant women to take both before travel and while abroad. To improve the quality of pretravel counseling for patients before or during pregnancy, we have created 2 tools: a guide for assessing the pregnant patient's risk during travel and a pretravel checklist for the obstetric provider. Evidence Acquisition: A PubMed search for English-language publications about travel during pregnancy was performed using the search terms "travel" and "pregnancy" andwas limited to those published since the year 2000. Studies on subtopics were not limited by year of publication. Results: Eight review articles were identified. Three additional studies that analyzed data from travel clinics were found, and 2 studies reported on the frequency of international travel during pregnancy. Additional publications addressed air travel during pregnancy (10 reviews, 16 studies), high-altitude travel during pregnancy (5 reviews, 5 studies), and destination-specific illnesses in pregnant travelers. Conclusions and Relevance: Travel during pregnancy including international travel is common. Pregnant travelers have unique travel-related and destination-specific risks. We review those risks and provide tools for obstetric providers to use in counseling pregnant travelers. Target Audience: Obstetricians and gynecologists, family physicians, and midwives. Learning Objectives: After completing this activity, the learner should be better able to ask appropriate questions of women who are planning travel during pregnancy; understand the increased risks borne by pregnant women who travel, especially to locations with limited medical resources and/or high rates of foodborne, waterborne, or mosquito-borne illnesses; counsel women about precautions regarding air travel including reducing risk of venous thromboembolism; and counsel women about destination-specific risks or feel empowered to refer women to travel clinics for patients with comorbidities, planning travel to high-risk destinations, orwho require immunizations not used for routine vaccination of US patients.