Chickenpox during pregnancy

KEY POINTS

  • Chickenpox is an infection caused by a virus. If you get it during pregnancy, it can cause problems for you and your baby. 

  • You’re probably safe from chickenpox if you’ve had it before or if you’ve had the vaccine. Both of these help make you immune to chickenpox.

  • Talk to your health care provider to make sure you’re immune to chickenpox before you get pregnant or early in pregnancy. 

What is chickenpox?

Chickenpox is an infection caused by a virus called the varicella-zoster virus. Chickenpox used to be a common infection, especially in children under age 12. It’s less common now because a vaccine is available to help prevent it. A vaccine is medicine that makes you immune to certain diseases.

Chickenpox usually isn’t dangerous in children. But some people are at higher risk for complications from chickenpox, including pregnant people and newborns. 

The chances of getting chickenpox during pregnancy are low. Most pregnant people are immune to chickenpox because they’ve had the infection before or they’ve been vaccinated against it. Talk with your health care provider to make sure you’re immune to chickenpox before you get pregnant or early in pregnancy.

What are the symptoms of chickenpox?

Chickenpox causes an itchy rash that turns into blisters and then scabs. The rash usually starts on the chest, back, and face and spreads all over the body. The rash appears about 10 to 21 days after you’re infected and can last 5 to 10 days.

Other symptoms can include fever, headache, being tired and not being hungry. These symptoms may appear 1 to 2 days before the rash.

How does chickenpox spread?

If you’re not immune to chickenpox, you can get it easily by being in contact with someone who has the infection. A person with chickenpox can spread the infection starting about 2 days before the rash appears and until all the blisters are covered by scabs. It can spread through:

  • Droplets in the air when someone with chickenpox coughs or sneezes
  • The saliva (spit) or mucus of someone with chickenpox
  • Touching a chickenpox rash

If you’re not immune to chickenpox, you can also get it through close contact with someone who has shingles. Shingles is an infection caused by the same virus that causes chickenpox. If you’ve had chickenpox before, the virus stays in your body and can come back later as shingles. Shingles causes a painful rash on one side of the face or body. People with shingles can spread chickenpox to other people, but they can’t spread shingles to other people.

Can chickenpox during pregnancy cause problems for you and your baby?

Yes. Having chickenpox during pregnancy can increase your risk of getting pneumonia and can even be life-threatening. Pneumonia is a lung infection that can be very serious. The symptoms of pneumonia include cough, chest pain when you breathe or cough, fever, fatigue (being very tired) and shortness of breath.

Chickenpox during pregnancy can cause these problems for your baby:

If you get chickenpox during the first 20 weeks of pregnancy, your baby may have an increased risk for congenital varicella syndrome. This is a rare group of serious birth defects that can cause:

  • Scars on the skin
  • Problems with the arms, legs, brain and eyes
  • Gastrointestinal complications
  • Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces.

If you get chickenpox between 2 weeks before birth to 2 weeks after birth, you can pass the infection to your baby. If this happens, the infection in your baby usually is mild.

If you get  chickenpox immediately before or right after birth (5 days before birth to 2 days after birth), your baby may have an increased risk for a serious infection called neonatal varicella. This infection can be life-threatening, but treatment is helping more babies survive.

If you have a preterm birth, your newborn may be at higher risk of complications from chickenpox. Preterm birth is birth that happens before 37 weeks of pregnancy.

Can you prevent chickenpox?

Yes. The varicella vaccine can protect you from chickenpox. In fact, this vaccine prevents more than 3.5 million cases of chickenpox each year. But the vaccine is not safe to get during pregnancy.

Talk to your provider if you’re pregnant or planning a pregnancy and you’re not sure if you've had the vaccine or had chickenpox before. Your provider can do a blood test to find out if you’re immune.

If you aren’t immune, how can you protect yourself from chickenpox during pregnancy? 

If you’re planning a pregnancy and the blood test shows you’re not immune, get vaccinated. You get the vaccine in two doses. It’s best to wait 3 months after the second dose before getting pregnant.

If you’re already pregnant, don’t get the vaccine until after you give birth. In the meantime, stay away from anyone who has chickenpox or shingles.

Tell your provider right away if you’re pregnant and you come into contact with someone who has chickenpox. Your provider can treat you with medicine that has chickenpox antibodies. Antibodies help the body fight infections. It’s important to get treatment within 10 days after you’ve come into contact with chickenpox to help prevent the infection or make it less serious. And tell your provider if you come in contact with a person who has shingles. Your provider can decide if you need treatment to help prevent you from getting infected.

How is chickenpox diagnosed?

Your provider can tell you if you have chickenpox by doing a physical exam. Your provider may do a blood test or take a swab of the rash and send it to a laboratory for testing to be sure it’s chickenpox.

How is chickenpox treated during pregnancy?

If you get chickenpox during pregnancy, your provider may give you an antiviral medicine such as acyclovir or valacyclovir. An antiviral is a medicine to treat infections caused by viruses. These medicines are safe to use during pregnancy. They work best when given within 24 hours of the chickenpox rash appearing.

If you have chickenpox and develop signs or symptoms of pneumonia, your provider may want you to stay in the hospital and be treated with acyclovir through an IV (through a needle into a vein). 

If you get chickenpox during pregnancy, how is your baby treated after birth? 

If you have chickenpox during pregnancy, your baby’s provider may treat your baby right after birth with medicine that has chickenpox antibodies. The medicine can help prevent chickenpox in your baby or make it less dangerous. If your baby gets chickenpox in the 2 weeks after birth, your baby may also be treated with antiviral medicine. 

Can you get chickenpox from someone who has gotten the vaccine? 

Yes, but it’s rare. If a vaccinated person gets chickenpox, they can still spread it to others. But the vaccine is more than 90 percent effective at preventing chickenpox. Providers recommend that children get their first dose of the varicella vaccine at 12 to 15 months of age and the second dose at age 4 to 6. 

Last reviewed: May, 2021