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Effects of Chickenpox on Pregnant Women and Fetuses
by Marjorie Greenfield, M.D. and Lynn Cates, M.D., F.A.A.P.
reviewed and revised by Marjorie Greenfield, M.D.
Many people consider chickenpox to be a childhood virus, which is not surprising since the infection most often affects children. But chickenpox (or varicella) occurs in adults as well, and when it does, it often is much more severe than it is in children. It can have particularly serious consequences if it develops during pregnancy.
Chickenpox and the fetus
- Chickenpox in the first half of pregnancy
It is important to keep in mind that most babies are born healthy even if their mother does get chickenpox during pregnancy. However, early pregnancy chickenpox can infect the fetus and cause severe birth defects such as small deformed arms or legs, skin scars, eye problems, mental retardation, prematurity, and early death; this rare but devastating condition is known as congenital varicella syndrome. If a mother contracts chickenpox during pregnancy, the expectant parents should have an in-depth conversation with their obstetrician about their options.
- Late third-trimester chickenpox
If the mother gets chickenpox anywhere from five days prior to delivery to two days afterward, the virus can be transmitted to the baby and make him severely ill. Infants in this situation usually are given a dose of anti-varicella antibodies (varicella-zoster immunoglobulin or VZIG) at birth to help fight off potential infection.
- General effect of mother-to-be's severe illness
Just as with any other serious disease, if a pregnant mother becomes very ill with chickenpox, her medical condition can injure the fetus indirectly--as a result of low maternal oxygen levels, for example, or stress-induced premature labor.
Chickenpox and the mother-to-be
- Who is at risk?
Since most adults had chickenpox as children, it's uncommon for a woman of childbearing age to be susceptible to the disease. Only about 5 percent are susceptible nowadays. Even women who don't remember having chickenpox usually are found to have had it (perhaps in a mild form) if given a blood test, and therefore aren't at risk for acquiring the virus in pregnancy.
Nevertheless, a female of childbearing age who doesn't know if she has had the disease should be tested. If she is susceptible, she can get the chickenpox vaccine and protect herself from getting infected during pregnancy. If the question of whether or not a woman is immune doesn't come up until she is already pregnant and has been exposed to chickenpox, blood testing can determine if she should receive treatment.
Please note: It's very important for women and children who might be infected with chickenpox to avoid the OB's waiting room. There may be other non-immune moms sitting there who could catch an infection from this kind of exposure. If there is a question about chickenpox exposure in pregnancy, a telephone call to the doctor is the safest way to start the evaluation and treatment procedures.
- Prevention
If a non-immune woman gets exposed to chickenpox during pregnancy, she usually will be given an injection of VZIG, which contains chickenpox-fighting antibodies. VZIG doesn't always prevent the woman from becoming infected, but it may lessen the severity of her symptoms.
- Dangerous side effects of infection
Coming down with chickenpox while expecting is not a good thing. Pregnancy weakens a woman's immune system, affecting the body's ability to fight off certain viruses including varicella. Because of this, pregnant women can become very ill and even die from this infection. If an expectant mother does get varicella, it can spread to her lungs, causing pneumonia that can be life-threatening.
Because the disease can be so severe, pregnant women with chickenpox often are admitted to the hospital for observation and treatment. In addition to treating varicella exposure with the VZIG antibody injection described above, there are now antiviral drugs designed to treat the actual infection that have been deemed safe for use in pregnancy.
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Created October 13, 2001
Reviewed and revised August 12, 2004
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