RALEIGH, N.C. -- Health officials in North Carolina said a pregnant woman was among five people who died of pandemic H1N1 flu or similar symptoms in one week.

A spokeswoman for the Department of Health and Human Services would not say where the woman lived. All five died during the week of Oct. 25.

She was the second pregnant woman in North Carolina to die of the virus this year. In both cases, their babies survived.

Dr. Sarah Yavorski recommends all pregnant women get both the H1N1 and seasonal influenza shots at any time in their pregnancies. She said pregnant women are more susceptible to swine flu.

"Pregnancy changes your immune status, so pregnant women just get sicker with influenza and are much more likely to get very serious pneumonia -- sometimes becoming critically ill," she said.

Through Sept. 26, North Carolina reported only deaths and hospitalizations attributed to H1N1. On Sept. 27, the state expanded its reporting to cover hospitalizations and deaths attributed to any influenza-like illnesses.

The News & Observer of Raleigh reported that the change was ordered by the national Centers for Disease Control and Prevention.

Twelve deaths through Sept. 26, were attributed to laboratory-confirmed H1N1 virus. Since Sept. 27, the state says 32 North Carolinians have died from influenza-related viruses, including H1N1. That makes a total of 48 flu-related deaths in North Carolina this year.