Chickenpox (Varicella) During Pregnancy

What is chickenpox (varicella)?

Chickenpox is a viral infection that a baby can get from the mother before or during birth. If you have chickenpox when you are pregnant, the virus can infect the baby. It can be very dangerous to the baby if you get the disease early in pregnancy or close to the time of delivery.

Chickenpox is also called varicella.

How does it occur?

Chickenpox is caused by a virus called Varicella zoster. The virus is spread by through the air by infected people when they sneeze or cough. The disease also spreads through contact with infected chickenpox blisters.

If you have already had chickenpox, you are probably immune. This means that if you are exposed to chickenpox again, your body can fight off the infection and you will not have chickenpox again. However, once you have had chickenpox, the virus stays in your body and can later cause another disease called shingles, or herpes zoster. (If you have shingles while you are pregnant, there is a very slight risk of birth defects.)

What are the symptoms?

Symptoms usually appear 10 to 21 days after exposure to the virus. Symptoms of chickenpox include:

• itchy, blisterlike spots on the skin, which later break open and form a crust (scab)
• tiredness
• fever
• aches and pains.

Chickenpox is contagious for several days before symptoms appear.

When you have shingles, a group of sores forms on the skin. The sores may be very painful, but there are few other symptoms.

A newborn exposed to chickenpox during pregnancy may have such birth defects as deformed arms and legs, scars on the skin, eye problems, brain damage, or a small brain. In some cases the baby may die.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have a blood test. Currently there is no sure way of determining whether the baby has been infected until after the baby is born.

How is it treated?

If you are not immune and you are exposed to the virus, you can be treated with a shot of varicella zoster immune globulin (VZIG) while you are pregnant. When given within 72 hours after exposure, VZIG helps prevent an infection or, if you do become infected, helps the infection be less severe. (Adults are more likely than children to have complications from chickenpox, such as pneumonia.) It is not yet known if giving the shot to a pregnant woman helps to prevent infection in the baby.

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 of birth. The vaccine usually lessens the severity of the infection in the baby.

If serious symptoms develop in spite of treatment with VZIG, you or the baby may be given antiviral drugs, such as acyclovir. Antiviral drugs may help reduce the severity of the illness.

How long do the effects last?

If the baby is infected with the virus early during your pregnancy or around the time of delivery, the baby may have severe problems. Some of these problems may be lifelong. Possible problems include:

• 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.

If you have chickenpox within 5 days before delivery or within 2 days after your child's birth, the baby may get very sick and may die.

What can be done to prevent chickenpox?

If you have already had chickenpox, you are probably immune. Being immune means that if you are exposed to chickenpox again, your body can fight off the infection and you will not get sick. You can have a blood test to see if you are immune. If you are not yet pregnant and a blood test shows that you are not immune, you can be given shots of varicella vaccine. The vaccine will give you immunity and prevent infection. Do not try to get pregnant until at least 1 month after you get the shots of vaccine. You should not get the vaccine if you are already pregnant.

Unless you know you are immune, you should avoid contact with children who have chickenpox when you are pregnant.