Viral Infections During Pregnancy

If you are pregnant, it’s important to take precautions against viral infections. A viral infection is a contagious illness. Most viruses will not hurt your baby. However, some viruses can cause miscarriage or birth defects. A virus can affect your respiratory tract (breathing) and can cause other symptoms. The flu and the common cold are examples of viral infections. Other examples are:

• Chickenpox (varicella)
• Fifth disease
• Cytomegalovirus
• Rubella (also called German measles)
• Zika virus
• COVID-19

Pregnant women can be exposed to people with viral infections. They spread directly through touching, kissing, or sexual activity. You can also get them indirectly, through coughing or sneezing. They can spread through contact with infected surfaces, food, and water. Just being exposed doesn’t mean you will become sick.

Path to improved health

Contact your doctor right away if you are pregnant and exposed to someone who has a viral infection. The doctor will want to know which virus and what type of contact you had. They also may ask about your symptoms.

Here are some questions your doctor may ask:

• Did you touch or kiss the infected person?
• How long were you in contact with the infected person?
• When did the infected person get sick?
• Did a doctor diagnose the infected person’s illness? Were any tests done?

What if I’m exposed to influenza?

Influenza can be more serious for pregnant women. You may get very sick. However, it hardly ever causes birth defects in the baby. If you are pregnant during flu season (October through March), you should get a flu shot.

What should I do if I’m exposed to chickenpox?

Chickenpox is caused by the varicella virus and is highly contagious. It can be serious during pregnancy. Sometimes, chickenpox can cause birth defects. If you have had chickenpox in the past, it is unlikely you will catch it again. If you have not had it or if you are not sure, see your doctor. Your doctor will test your blood to see if you are immune.

Many people who don’t remember having chickenpox are immune. If your blood test shows that you are not immune, you can take medicines to make your illness less severe and help protect your baby from chickenpox.

What should I do if I’m exposed to fifth disease?

Fifth disease is a common virus in children. About half of all adults are sensitive to fifth disease and can catch it from children.

Children who have fifth disease often get a rash on their body and have cold-like symptoms. Their cheeks may be red and look like they’ve been slapped or pinched. Adults who get fifth disease do not usually have the “slapped cheek” rash. Adults will often have very sore joints.

If you get fifth disease early in your pregnancy, you could have a miscarriage. It also can cause birth defects in your baby, such as severe anemia. Call your doctor if you are exposed to fifth disease. Your doctor may have you take a blood test to see if you’re immune. You also may need an ultrasound exam to see if the baby has been infected.

What if I’m exposed to cytomegalovirus?

Cytomegalovirus usually doesn’t cause any symptoms. This makes it hard to know if you have it. It is the most common infection that can be passed from mother to baby. Cytomegalovirus affects 1 of every 100 pregnant women. It can cause birth defects, such as hearing loss, development disabilities, or even death of the fetus.

It’s important to prevent cytomegalovirus because there is no way to treat it. Women who work in day care centers or a health care setting have the highest risk of getting infected. Pregnant women with these jobs should wash their hands after handling diapers and avoid snuggling or kissing the babies. If you think you’ve been exposed to a person who has cytomegalovirus, see your doctor right away.

What if I’m exposed to rubella?

Since 1969, almost all children have had the rubella vaccine, so it is a rare disease today. At the first prenatal visit, all pregnant women should be tested to see if they are immune to rubella. Women who are not immune should get the vaccine after the baby is born. Talk to your doctor if you are trying to become pregnant. Then you can get the vaccine in advance if you are not immune.

Symptoms of rubella in adults are joint pain and a possible ear infection. The virus can cause severe birth defects or death of the fetus. Talk to your doctor if you have these symptoms or have been exposed.

What if I’m exposed to measles?

Measles (also called rubeola) is a serious respiratory illness that affects the lungs and breathing tubes. It also causes a rash and a fever. It is one of the most contagious diseases there is, and it can be spread to others very easily. In rare cases, it can be deadly. If you are thinking of becoming pregnant or are pregnant, talk to your doctor about a measles vaccination. If you are traveling, you are at a higher risk of getting measles. One person infected by measles can infect 9 out of 10 of their unvaccinated close contacts. Many countries and popular travel destinations have experienced measles outbreaks in recent years. Most were among children who had not received measles-mumps-rubella (MMR) vaccine. To prevent measles infection and prevent its spread, all U.S. residents should be up to date on their MMR vaccinations, especially prior to international travel regardless of the destination.

What if I’m exposed to Zika virus?

The Zika virus is a travel-related virus that can cause birth defects if a woman is exposed during pregnancy. Zika outbreaks have been reported in South America, Central America, and North America. The virus can cause microcephaly (the baby’s head and brain are smaller than normal. This causes an intellectual disability).

The infection is transmitted through an infected mosquito bite or is passed to a woman through sexual contact. Women who are pregnant or hope to become pregnant should avoid travel to these regions and use a condom during sex if your partner has traveled to the area. Your doctor will tell you how long you must wait before trying to become pregnant if your partner has been exposed to the virus.

Things to consider

Most other viruses do not seem to increase the natural risk for birth defects. This includes viruses such as regular measles, mumps, roseola, mononucleosis, and bronchiolitis. In normal pregnancies, the risk of serious birth defects is 2% to 3%.

To protect yourself from all infectious viruses:

• Wash your hands frequently, especially after using the restroom or before a meal.
• Avoid contact with people who are sick, infected or in close contact with others who are.
• Get a flu shot and other vaccines either before or during pregnancy, as needed.

Contact your doctor right away if you have been exposed to an infected person or have symptoms of a virus. They can provide treatment, if possible, and monitor your baby for signs of infection.

Questions to ask your doctor

• How do I know if I’ve been exposed to someone infected with a virus?
• What can I do to prevent exposure?
• How do I know if I’m immune to certain viruses?
• At what point should I get a flu shot?
• Are there any other vaccines I should get before or during pregnancy?