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.