How five common childhood infections can affect pregnancy.
Not Just for Kids
Would you pass up the chance to hug your friend's toddler or hold her baby? Unlikely. No one can resist cuteness, but those chubby little hands could be carrying more than teething biscuits. Their fingers are often in their mouth, nose, and, yes, their diapers -- creating perfect living conditions for germs. Fortunately, most illnesses won't harm your unborn baby, although there are a few you should look out for. Here's a rundown of common viruses kids are exposed to and what you need to know about them.
The Common Cold
Got the sniffles? A cold isn't dangerous, although it is uncomfortable, starting with a runny nose, followed by nasal stuffiness and often a sore throat, headache, mild body aches, and a low fever.
What to do: For the one to two weeks that colds last, rest and drink lots of fluids. Hot liquids can ease congestion, as may a saline nasal spray.
If you have a temperature that is over 100 degrees, contact your healthcare provider. You may have an illness other than a cold, such as the flu or strep throat. Or he might recommend acetaminophen (e.g. Tylenol) to bring down your fever. If your cold is interfering with your ability to eat or sleep, your doctor may recommend the safest medication (a decongestant or antihistamine, for example) to give you some relief. Many physicians believe that chlorpheniramine (the antihistamine found in medications like Chlor-Trimeton) is among the safest because pregnant women have used it for many years and it doesn't appear to cause birth defects or other complications. If you need a decongestant, some doctors recommend oxymetazoline, which comes in nasal-spray or drop form (such as Afrin and Dristan Long Lasting), because only a small amount of it is absorbed into your system.
Always use a cold medicine that contains only the ingredient your provider recommends (many are made with more than one drug). Also, avoid cold medications that contain iodine, which can cause serious thyroid problems in your baby, as well as herbal remedies, because most have not been tested for safety in pregnancy.
Unlike a cold, the flu comes on quickly with fever (as high as 103 degrees), headaches, muscle aches, chills, sore throat, and cough. You'll start to feel better after about four days, but the cough and fatigue can linger for two weeks or more.
What to do: A high fever during pregnancy may be harmful, so contact your physician if you suspect the flu. Moms-to-be are at increased risk for complications, such as pneumonia, so call your doctor again if you don't feel better after several days, your cough worsens, or you're having trouble breathing. The Centers for Disease Control and Prevention recommends that women who will be pregnant from October through mid-May -- the flu season -- get vaccinated. (Expectant moms, however, shouldn't get Flumist, the nasal spray vaccine.)
Chickenpox, Fifth Disease & Cytomegalovirus
Up to 3 in 1,000 expectant mothers come down with this illness every year. This viral infection's telltale signs are an itchy rash and fever. Fortunately, about 90 percent of pregnant women are immune because they had it during childhood. If you think you've never had it, avoid anyone with chickenpox. Contracting it during the first 20 weeks of pregnancy puts your baby at a slightly increased risk of certain birth defects, including limb malformation, blindness, and mental retardation. A Lancet study published last year suggests that chickenpox in the third trimester may also affect brain development. And if you get it five days before to two days after delivery, your baby can develop a severe chickenpox infection.
What to do: If you've never had the disease and were exposed to someone with it, call your doctor. Prompt treatment with varicella-zoster immune globulin can help prevent it or lessen its severity. If you're not yet pregnant and haven't had chickenpox, ask your doctor about receiving the chickenpox (varicella) vaccine. If you get it, wait a month before trying to conceive.
This illness results in a distinctive "slapped cheek" rash in kids and sometimes a mild fever, headache, sore throat, and joint pain. About 60 percent of moms-to-be had the infection in childhood and are immune.
While any susceptible adult can get fifth disease, those with young kids or who work with them are at greatest risk. Infected adults often experience joint pain, swelling, and sometimes mild flulike symptoms, but are less likely to develop a rash. About half have no symptoms. Most likely, your baby will be unaffected, but it can lead to miscarriage or stillbirth.
What to do: If you are exposed to someone with fifth disease, contact your doctor. She may recommend a blood test to detect whether you've had or currently have it. While no drugs can treat it, your doctor can monitor you for signs of fetal problems. In severe cases, an intrauterine blood transfusion might be needed.
Cytomegalovirus (CMV) is the most common virus passed from mom to baby during pregnancy, infecting about 1 percent of all newborns. Most babies born with it aren't harmed, but about 10 percent become seriously ill, a small number die, and many survivors develop one or more neurological abnormalities, such as mental retardation, learning problems, and hearing or vision loss.
What to do: You're at increased risk of contracting CMV if you have young kids or work with them. There's no treatment for CMV, but you can try to avoid it by washing your hands well after any contact with bodily fluids, such as after changing diapers or touching tissues. Avoid sharing drinking glasses or utensils too. Most adults don't have symptoms, but some develop fever, swollen glands, fatigue, and a sore throat. A blood test can diagnose or rule out CMV, but 50 to 80 percent of adults have had it, and although CMV stays in your system and can flare up during pregnancy, first-time infections in the first half of pregnancy are most problematic. The good news: This is uncommon.
Richard H. Schwarz, MD, obstetrical consultant to the March of Dimes and past president of the American College of Obstetricians and Gynecologists, is vice chairman for clinical services, in the obstetrics and gynecology department at Maimonides Medical Center, in Brooklyn, New York.
Originally published in American Baby magazine, December 2006.
The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.