Chickenpox and Pregnancy

Chickenpox is an infectious disease. Chickenpox is highly contagious and spreads from person to person by direct contact or through the  air from an infected person’s coughing or sneezing. A person with chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs. It takes from 10-21 days after contact with an infected person for someone to develop chickenpox.

If a pregnant woman gets chickenpox while in the first or early second trimester of pregnancy, there is a small chance (0.4 – 2.0%) that the baby could be born with birth defects known as "congenital varicella syndrome." This usually means the baby will have limb atrophy and scarring of the skin. Sometimes there are problems with the central nervous system and eye abnormalities.

Prevention

To protect an unborn baby, pregnant women should:

• If a pregnant woman has never had the chickenpox, she should get vaccinated at least one to three months before becoming pregnant. She should not get vaccinated during pregnancy or less than one month before becoming pregnant.
  
  
• If a pregnant woman is susceptible to chickenpox (she has never had chickenpox and has not been vaccinated), and she lives with someone who is also susceptible, that person should get vaccinated. Vaccinating close contacts of a susceptible pregnant woman is the most effective way to protect against the disease.
  
  
• If a pregnant woman is susceptible to chickenpox, as soon as she delivers the baby, she should be vaccinated. The first dose of vaccine can be given before she is discharged from the hospital and the second dose at the 6-week post-partum visit. The vaccine is safe even for mothers who are nursing.
  
  
• Stay away from anyone who has chickenpox. This includes people who have been vaccinated and then get a very mild form of the disease (usually little or no fever and fewer than 50 skin lesions), called “breakthrough” chickenpox. “Breakthrough” chickenpox is still contagious and can lead to serious complications.
  
  
• If a pregnant woman is susceptible to chickenpox and finds out that she has been exposed (or been in contact with) someone who has chickenpox, she should call the doctor immediately.

 

Symptoms

A rash appears first on the trunk and face, but can spread over the entire body typically causing 250-500 itchy blisters in people who have never been vaccinated against chickenpox. In people who have been vaccinated, the rash can be quite mild, such as only a few spots resembling mosquito bites.

Chickenpox most commonly causes an illness that lasts about 5-10 days. Other symptoms include high fever, severe itching, an uncomfortable rash, dehydration from vomiting or diarrhea, headache, infected skin lesions, exacerbation of asthma or more serious complications such as pneumonia.

Certain groups of persons are more likely to have more serious illness with complications. These include adults, infants, adolescents and people with weak immune systems from either illnesses or from medications, such a long-term use of steroids.

Serious complications from chickenpox include bacterial infections which can involve many sites of the body including the skin, tissues under the skin, bone, lungs (pneumonia), joints and the blood. Other serious complications are due directly to the virus infection and include viral pneumonia, bleeding problems and infection of the brain (encephalitis).

Many people are not aware that, before a vaccine was available, there were approximately 11,000 hospitalizations and 100 deaths from chickenpox in the U.S. every year. One child and one adult died each week.

Getting chickenpox even though the person has been vaccinated is not uncommon, since the chickenpox vaccine is not 100% effective in preventing disease.