Chickenpox and Pregnancy
Chickenpox (varicella) spreads easily and is usually mild in childhood, but it can cause more serious problems during pregnancy. The varicella-zoster virus passes from person to person through direct contact or by breathing in droplets from someone with chickenpox. When a pregnant person gets chickenpox, both they and their baby can face health risks.
Main Health Concerns for Pregnant People
Pregnant individuals who contract chickenpox face a higher risk of complications than the general population. This is largely due to changes in the immune system during pregnancy.
- Severe Pneumonia: Pregnant people have a higher chance of getting pneumonia from chickenpox. This lung infection can be severe and sometimes life-threatening.
- Intense Symptoms: Chickenpox can cause worse symptoms during pregnancy, like high fever, extreme tiredness, and body aches.
Risks to the Unborn Baby
The dangers to the baby depend on when the infection happens:
| Pregnancy Stage | Possible Risks to Baby |
|---|---|
| Before 20 weeks (esp. 8-20 weeks) | Congenital varicella syndrome with risk for birth defects such as skin scarring, eye problems, small head size, brain abnormalities, and malformed limbs. |
| Last weeks, close to delivery | Neonatal varicella, which may be severe and even life-threatening. |
Congenital Varicella Syndrome
If a pregnant person gets chickenpox in early pregnancy (especially weeks 8 to 20), the baby has a small risk of developing congenital varicella syndrome. Symptoms of this rare condition can include:
- Skin scars
- Malformation of arms and legs
- Eye defects (possibly blindness)
- Problems with brain development, including a smaller than normal head size
- Seizures or developmental delays
- Problems with the digestive system
These health concerns may affect the child’s long-term growth and development. Doctors can sometimes find these health issues during pregnancy by ultrasound.
Neonatal Varicella
If a mother gets chickenpox just before or right after giving birth, the baby could be born with neonatal varicella. The baby’s immune system cannot fight the infection well, so neonatal varicella can cause severe illness and may be life-threatening.
- Symptoms may include rash, fever, breathing difficulty, and lethargy.
- This form of chickenpox typically appears within 5 to 10 days after birth if transmitted at delivery.
Immunity and Prevention
Most people are immune to chickenpox because they had it before or got the chickenpox vaccine. Immunity means the person has antibodies that protect against chickenpox. Knowing your immune status is important during pregnancy. A blood test early in pregnancy often checks for immunity. If someone does not have immunity and gets exposed to chickenpox:
- The doctor may give zoster immune globulin, which contains antibodies against the chickenpox virus.
- If given within 10 days of exposure, zoster immune globulin can lower the chances of getting chickenpox or make the illness milder.
This treatment may also reduce the severity of illness in the unborn baby, although research is still ongoing about its full protective effect. If chickenpox develops during pregnancy:
- The doctor often prescribes antiviral medicine, which helps reduce symptoms and shorten recovery time.
- This medicine works best if started within 24 hours of the rash.
Management for Newborns
If the mother has chickenpox around the time of delivery:
- The newborn may get immune globulin soon after birth to help prevent or lessen neonatal varicella.
- If a newborn shows signs of chickenpox in the first weeks of life, doctors start antiviral medicine to treat the infection.
Monitoring may also include checking vital signs, oxygen levels, and ensuring the baby is feeding well.
Vaccination and Planning Ahead
The chickenpox vaccine is safe for adults who are not pregnant and have no immunity. Women planning pregnancy can get the vaccine, but should wait at least one month after the last dose before trying to become pregnant. Vaccination before pregnancy is the best way to prevent chickenpox complications.
- The vaccine is given in two doses, usually spaced 4 to 8 weeks apart.
- After vaccination, immunity is generally long-lasting, reducing future risk during pregnancy.
If you are unsure of your immunity status, talk to your healthcare provider about getting a blood test or vaccination before becoming pregnant.
