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| |    Chickenpox and Pregnancy by Marjorie Greenfield, M.D. and Lynn Cates, M.D., F.A.A.P. reviewed by Elisa Ross, MD When we think of chickenpox, most of us remember an itchy, bumpy childhood rash and fever that kept us away from regular activities for several days. This illness usually is not severe in children, but it can be quite serious in those who don't have healthy immune systems and in adults. If a pregnant woman catches chickenpox, it can cause serious problems for both mother and fetus. Varicella, the virus that caused chickenpox, is extremely contagious: During childhood, about 85 to 95 percent of unvaccinated individuals contract chickenpox. Once you've had chickenpox, you usually don't get it again. A chickenpox vaccine was licensed in 1995 for routine use in children beginning at age 12 months, but the disease will be with us for quite some time because many people still are not protected. The vaccine wasn't available when women who currently are of childbearing age were growing up, but most developed immunity after contracting this common childhood disease. However, research has shown that about 5 percent of pregnant women are still susceptible to chickenpox. The difference between chickenpox and shingles Illness from the varicella virus comes in two forms: as chickenpox, with its itchy skin bumps and generalized signs of viral infection such as fever and fatigue; and as a reactivation of the virus in the form of a small area of painful or itchy infected skin called herpes zoster, varicella zoster, or shingles. Chickenpox is the illness that you get the first time you are exposed to the virus; shingles is a reactivation of your old virus (that is, you don't "catch" shingles from someone else, your own virus makes you sick again). Both these illnesses are contagious, but the chickenpox form of the disease is much more contagious than the zoster form because people with chickenpox are shedding much larger amounts of the virus. If a pregnant woman gets shingles, usually neither she nor her fetus face significant risks because she already has good immunity to the varicella zoster virus that will protect her baby. It's just an annoyance. On the other hand, chickenpox is more likely to cause serious medical problems if the infection occurs in the first 28 weeks of pregnancy. Preventing varicella infection in pregnancy Women who plan to have children should find out if they indeed had chickenpox as a child (usually their parents will know). If they haven't or don't know for sure, a simple blood test can check to see if they are immune. Women found to be at risk for infection should be vaccinated. The varicella vaccine is in FDA category C, which in this case means that risk to the fetus has not been studied. Because of this, it's best to be fully immunized against chickenpox at least three months before conception is planned. Since people 13 years and older need two doses of vaccine given four to eight weeks apart, a woman will need to start getting immunized at least four months before she plans to conceive.
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