Chickenpox during Pregnancy

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KEY POINTS

• Chickenpox is an infection caused by the varicella virus. Most adults don’t get chickenpox. A baby can get the chickenpox virus from the mother before or during birth. The infection can be very dangerous to the baby if a woman is infected early in pregnancy or close to the time the baby is born.
• If you are exposed to the virus and have not had chickenpox or the chickenpox vaccine, you can be treated with a shot of varicella zoster immune globulin (VZIG) while you are pregnant. If you develop a chickenpox rash 5 days before or 2 days after the birth of your baby, the baby may be given VZIG within 72 hours after birth. If you or the baby have serious symptoms in spite of treatment with VZIG, you or the baby may be given antiviral drugs.
• A vaccine is available to protect against chickenpox. If you are not yet pregnant and a blood test shows that you are not immune to chickenpox, you can get the varicella vaccine.

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What is chickenpox?

Chickenpox is an infection caused by the varicella virus. Chickenpox is also called varicella.

Most adults don’t get chickenpox because they had chickenpox as a child or have had the shot that protects against chickenpox. They are immune, which means that their body can fight off another infection and they do not get sick. However, when a teen or adult is not immune and does get chickenpox, the infection can be more serious than it is in children. Also, after you have the infection, the virus stays in your body for the rest of your life. The virus can later cause shingles. Shingles causes a painful, blistering rash, usually in one area, like the back or face, on one side of the body. If you have shingles while you are pregnant, there is only a very slight risk of birth defects.

How does chickenpox during pregnancy affect the baby?

A baby can get the chickenpox virus from the mother before or during birth. The infection can be very dangerous to the baby if a woman is infected early in pregnancy or close to the time the baby is born. If the baby gets infected, the baby may have severe problems, such as:

• Skin scarring
• Weak arms and legs
• Eye problems, such as an eye infection or cataracts
• Small brain
• Problems with the development of the hands and feet

In some cases the baby may die.

What is the cause?

Anyone who has not had chickenpox or the chickenpox shot can get chickenpox. The virus can be easily passed to other people in several ways:

• It can spread through the air by infected people when they sneeze or cough.
• It can spread if you touch the chickenpox sores and don’t carefully wash your hands afterwards.
• It can spread if you have close contact with someone who has shingles.

What are the symptoms?

Symptoms usually appear 10 to 21 days after you are exposed to the virus. The symptoms include:

• A red, itchy, rash of small, fluid-filled blisters or sores that usually appear first on the face, scalp, chest, or back
• Feeling tired and irritable
• Fever
• Body aches and pains
• Mild headache

If untreated, some pregnant mothers with chickenpox infection can get pneumonia, which can cause death.

Chickenpox is contagious 1 to 2 days before you see the rash. It stays contagious until all of the blisters have crusted over. This usually takes 4 to 7 days.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. If you are not sick but you have been exposed to chickenpox, you may have a blood test to see if you have already had chickenpox and are immune to the infection. When you are pregnant, there is no sure way to check if your baby has been infected until after the baby is born.

How is it treated?

If you are exposed to the virus and have not had chickenpox or the chickenpox vaccine, you can be treated with a shot of varicella zoster immune globulin (VZIG) while you are pregnant. If you get this shot within 72 hours after you are exposed to chickenpox, VZIG helps to keep you from having chickenpox. If you do still get chickenpox, it helps the infection be less severe. Doctors don’t know if the VZIG shot helps to keep the unborn baby from getting infected.

If you develop a chickenpox rash 5 days before or 2 days after the birth of your baby, the baby may be given VZIG within 72 hours after birth. It usually lessens the severity of the infection in the baby.

If you or the baby have serious symptoms in spite of treatment with VZIG, you or the baby may be given antiviral drugs. Antiviral drugs may help the illness be less severe.

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Talk to your healthcare provider if itching is severe or mouth sores make it hard to eat.
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent chickenpox?

A vaccine is available to protect against chickenpox. Two shots of the varicella vaccine are recommended for people 13 years or older who have not had chickenpox and who have not been previously vaccinated. If you have had chickenpox or the chickenpox shot and get pregnant, you are immune and both you and your baby are protected against the infection.

If you are not yet pregnant and a blood test shows that you are not immune to chickenpox, you can get the varicella vaccine. Don’t try to get pregnant until at least 1 month after you get the vaccine. You should not get the vaccine if you are already pregnant.

Unless you know you are immune, you should avoid close contact with anyone who has chickenpox or shingles when you are pregnant.