Chickenpox, a common childhood illness caused by the varicella-zoster virus (VZV), is often dismissed as a mild infection. But for pregnant women, it’s a different story. Contracting chickenpox during pregnancy can lead to serious complications for both the mother and the developing baby. Understanding these risks—and knowing how to mitigate them—is critical for expectant mothers and those planning a pregnancy.
Why Chickenpox Poses a Unique Threat During Pregnancy
Chickenpox is highly contagious, spreading through respiratory droplets or direct contact with fluid from the blisters. While most children recover without issues, adults—including pregnant women—face a higher risk of severe symptoms. During pregnancy, a woman’s immune system undergoes changes to protect the growing fetus, which can make her more vulnerable to infections like chickenpox.
The virus doesn’t just affect the mother. If contracted during specific stages of pregnancy, it can cross the placenta and harm the baby, leading to congenital disabilities, preterm birth, or even life-threatening infections after delivery. Let’s break down the risks and precautions in detail.
Risks to the Mother
Pregnant women who contract chickenpox are 10–20% more likely to develop pneumonia compared to non-pregnant adults, according to the Centers for Disease Control and Prevention (CDC). Varicella pneumonia can become severe, requiring hospitalization and intensive care. Symptoms like high fever, cough, and difficulty breathing demand immediate medical attention.
Other maternal complications include hepatitis (liver inflammation), encephalitis (brain swelling), and secondary bacterial infections from scratching blisters. These risks are highest during the second and third trimesters, when the body’s immune response is further modulated to support fetal growth.
Risks to the Baby
The impact on the baby depends largely on when the mother is infected:
- First Trimester (Weeks 1–12): The risk of congenital varicella syndrome (CVS) is approximately 1–2%. CVS can cause scarring, limb abnormalities, eye defects, and neurological issues in the baby.
- Second Trimester (Weeks 13–20): The risk of CVS drops slightly, but abnormalities are still possible.
- Third Trimester (Weeks 21–40): If the mother develops chickenpox 5 days before to 2 days after delivery, the baby may develop neonatal varicella. Without treatment, this condition has a 20–30% mortality rate due to the baby’s underdeveloped immune system.
Prevention: The Best Defense
1. Check Your Immunity
Many people assume they’re immune to chickenpox because they had it as a child—but not everyone is. Blood tests can confirm immunity by detecting antibodies to VZV. If you’re planning a pregnancy and aren’t immune, the varicella vaccine is recommended at least one month before conception.
2. Vaccination
The varicella vaccine is a live-attenuated virus, meaning it’s not safe during pregnancy. However, it’s over 90% effective in preventing infection when administered pre-pregnancy. If you’re already pregnant and unsure of your immunity, avoid the vaccine until after delivery.
3. Avoid Exposure
Steer clear of individuals with active chickenpox or shingles (caused by the same virus). If someone in your household is infected, separate living spaces and avoid sharing items until all blisters have crusted over.
4. Post-Exposure Prophylaxis
If you’re exposed to chickenpox during pregnancy and aren’t immune, contact your healthcare provider immediately. Varicella-zoster immune globulin (VZIG), a blood product containing antibodies against VZV, can reduce infection severity if given within 10 days of exposure.
What If You Contract Chickenpox During Pregnancy?
1. Seek Immediate Care
Antiviral medications like acyclovir are most effective when started within 24 hours of the rash appearing. Studies show acyclovir is safe during pregnancy and can reduce complications like pneumonia.
2. Monitor for Severe Symptoms
Watch for signs of pneumonia (e.g., rapid breathing, chest pain) or dehydration. Hospitalization may be necessary for intravenous antivirals or oxygen therapy.
3. Protect the Baby
If you develop chickenpox near your due date, your healthcare team may recommend delaying delivery (if possible) to allow antibodies to transfer to the baby. After birth, the baby may receive VZIG or acyclovir to prevent neonatal varicella.
Case Study: A Real-Life Scenario
Sarah, 28, was 18 weeks pregnant when her toddler contracted chickenpox. Despite trying to isolate, Sarah developed a fever and rash five days later. She contacted her obstetrician immediately and started acyclovir. Though she had a tough week recovering, her baby showed no signs of CVS on ultrasound. Sarah’s prompt action highlights the importance of early treatment.
Breastfeeding and Chickenpox
If you have active chickenpox, you can breastfeed provided there are no blisters near the nipples. However, wear a mask and wash hands thoroughly to avoid spreading the virus. Pumping milk is also an option if direct contact poses a risk.
FAQs
Q: Can I get the chickenpox vaccine while pregnant?
A: No. The vaccine contains a live virus and is not recommended during pregnancy. Wait until after delivery.
Q: What if I’m exposed to shingles during pregnancy?
A: Shingles is less contagious than chickenpox, but direct contact with fluid from the blisters can transmit VZV. Consult your doctor if exposed.
Q: How soon after childbirth can I get vaccinated?
A: The vaccine can be administered immediately postpartum, even if breastfeeding.
Q: My child has chickenpox. Should I stay away?
A: If you’re immune, the risk is low. If not, limit close contact until the blisters crust over.
Q: Can chickenpox cause miscarriage?
A: While rare, severe infections in early pregnancy may increase miscarriage risk. Prompt treatment reduces this likelihood.