Chicken pox and Pregnancy, the risk factors and implications for both Mom and Baby’s health.

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Before looking at chicken pox and pregnancy and its concerns, we must first understand that pregnancy is considered a physiological low immunity state in which a woman is more vulnerable to infectious agents than in non pregnant state. The impact of any infection on progression of pregnancy depends on the trimester in which it’s contracted, counteracted and the individual body response to infectious agent.

Chicken pox, which is also known as Varicella, is a contagious infection or illness caused by Varicella-Zoster virus. It’s principally transmitted from one person to another through direct contact with already infected patient and contaminated air with virus released through talking, sneezing or coughing by any infected patient.

Chicken pox and pregnancy is not a very common combination but whenever it occurs, it’s a source of concern to any pregnant woman and her healthcare provider because the consequences are grave, both for the infected mom and baby.

What are the Important Risk Factors about Chicken pox and Pregnancy?

Virus infections are the most common kinds of dreaded illness among pregnant women due to their easy mode of transmission and low body immunity to fight disease during pregnancy. However, there’s good news about Chicken pox, which is considered a communicable disease (transmitted by contact with an already infected person). As a rule, once you’ve had chicken pox at any time in the past, you’re conferred with lifelong immunity against it, implying that you’re not at risk as a pregnant woman, if:

  • You had infection before pregnancy.
  • If you have been vaccinated against Chicken pox virus before getting pregnant. If you’re not sure about your vaccination, a clinical blood test or Tzanck smear can help you confirm your status.

Chicken pox and pregnancy: The Implications on Maternal Health

In the absence of any immunization or immunity, if anyone around you is suffering from active chicken pox infection, you’re very likely to contact it. The signs are same as that of non-pregnant state. The common symptoms of chicken pox during pregnancy are as follows:

  • Mild flu-like syndrome that spans 1-2 days
  • Fever and sore-throat
  • Itchy rash that degenerates into eruptions and active bumps of chicken pox, blistering as they get bigger and beginning mostly on the face, chest and gradually spread to other parts of the body.
  • Recurrent vomiting, diarrhea and severe headache
  • Pneumonia which manifests as a difficulty in breathing accompanied with cough or chest pain. It’s believed that infection during pregnancy is more severe and when it leads to complications like chicken pox pneumonia, being hospitalized may be necessary.

About 10-20% of pregnant chicken pox sufferers encounter chicken pox pneumonia especially if it occurs in third trimester. Moreover, the risk of more severe infection is higher than in non-pregnant woman. In case of severe third trimester infection, pre-term or pre-mature delivery may also occur.

Baby’s Health, Chicken pox and Pregnancy

Risk of complications from chicken pox during pregnancy depends on timing. Depending upon the trimester in which you’re infected with chicken pox, the possible complications for the baby vary. The risk of complications in the baby is highest in the first and second trimesters as these make up the period when all the baby’s major organs and systems are being formed.

Although risk on baby’s health is slight (about 0.4 - 1.5% only), but if Varicella virus is transmitted to the developing baby usually via the placenta, congenital varicella syndrome may occur. Congenital varicella syndrome leads to a variety of developmental and functional defects in the baby that constitute

  • Limb defects
  • Abnormally small head size and mental retardation.
  • Visual defects
  • Abnormalities of skin such as multiple scars
  • Fetal growth restriction and low birth weight
  • If any vital organs of the developing baby are involved, miscarriage may also occur.

Chicken pox and Pregnancy – Implications of infection during Third Trimester:

If any expecting mom gets infected during early third trimester, the risk of transmission and virus related complication is very low. In addition, it may confer immunity to the fetus by transmission of the antibodies, usually developed by any infected body after 5 days of infection, and passed from mother to baby via the placenta. This transmitted antibodies help the baby remain protected from any active infective source even after birth.

However, if a pregnant mom gets infected in late third trimester; a week before delivery or 2 days after delivery, formation and transmission of antibodies from mother to baby is not feasible thus resulting in active exposure of your baby to the virus. This increases the risk of the baby catching chicken pox. Such baby may either be born with active chicken pox infection, shingles or develop infection within the first 2 weeks of post-natal life (post-delivery life). Chicken pox in newborn babies is a very serious problem that may even lead to neonatal death.

The Treatment options for Chickenpox during Pregnancy?

Recent studies recommended administration of varicella zoster immune globulin (VZIG), a blood product made up of chickenpox antibodies. VZIG is given as an intramuscular injection, within 96 hours of exposure to reduce the severity of chicken pox contracted during pregnancy.

If a newborn shows any symptoms of chicken pox or shingles after birth, he or she can be treated with a full course of acyclovir.

Tips of Advice on coping with Chicken pox and Pregnancy

  • It’s recommended to avoid anyone actively infected with chicken pox.
  • If you begin to develop signs of chicken pox infection, consult your healthcare provider immediately and start anti-viral therapy like VZIG, acyclovir or even valacyclovir.
  • If you develop infection late in the third trimester of pregnancy and your baby is without any active lesion of chicken pox after delivery, your physician may prescribe baby vaccination to prevent infection.

Chicken pox and pregnancy are a deadly combination that must be prevented by vaccination of all the women of child-bearing age at least 1 – 3 months before getting pregnant; however chicken pox vaccination during pregnancy is not indicated or recommended. In fact, the Center for Disease Control and Prevention (CDC) advises women to get vaccinated 1 or 3 months before getting pregnant or get vaccinated immediately after childbirth, even while you’re breastfeeding but this vaccine is NOT administered during pregnancy.

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