Impact of Chickenpox During Pregnancy: Concerns for Newborn Health

Q: Impact of Chickenpox During Pregnancy: Concerns for Newborn Health

Hello, regarding your question, here are my responses： 1. Generally, chickenpox will resolve on its own. Additional medication is only necessary if the immune system is particularly weak or if the symptoms are especially severe. 2. Typically, when pregnant

Pregnant at 36 weeks with chickenpox?

Hello Doctor, my wife contracted chickenpox during her thirty-sixth week of pregnancy, and we are very concerned about the impact on our baby.
She is currently taking medication to maintain the pregnancy and will continue for at least two weeks until her chickenpox symptoms improve before delivery.
I have several questions:
1.
My wife is only using topical medication; does she need further treatment?
2.
If she delivers two weeks later, what is the likelihood of the newborn developing chickenpox?
3.
What treatments or preventive measures should be taken for the baby after birth?
4.
I found that most online discussions focus on pregnant women who develop chickenpox four days before delivery; what are the implications for the newborn if it occurs two weeks prior to delivery?
I have many questions, and I appreciate your response.
Sincerely, an anxious husband.

Mr. Y, 30~39 year old female. Ask Date: 2010/09/14

Dr. Lü Lizheng reply Obstetrics and Gynecology

Hello, regarding your question, here are my responses:
1.
Generally, chickenpox will resolve on its own.
Additional medication is only necessary if the immune system is particularly weak or if the symptoms are especially severe.

2.
Typically, when pregnant women contract the disease, they develop antibodies that not only protect themselves but also provide protection for the newborn, so there is no need for concern.

3.
As long as the pregnancy is beyond five months, the likelihood of the newborn being infected in utero is very low.
As long as the pediatrician checks the newborn after birth and finds no abnormalities, everything should be fine.

4.
Generally, antibodies provide protective effects for pregnant women after they have been ill for more than five days, and the protection is even better after two weeks.

Wishing you peace and health,
Dr.
Lu Li-Cheng, Director of the Department of Obstetrics and Gynecology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2010/09/14

More Info

Chickenpox, or varicella, poses significant concerns during pregnancy, particularly in the later stages. When a pregnant woman contracts chickenpox, especially in the third trimester, there are several potential implications for the newborn. Here’s a detailed response to your questions:
1. Further Treatment for Your Wife: If your wife is only using topical medications, it is essential to consult her healthcare provider for a comprehensive evaluation. While topical treatments can help alleviate itching and discomfort, systemic antiviral medications, such as acyclovir, may be recommended, especially if she develops severe symptoms or if there are concerns about complications. The timing of treatment is crucial, as antiviral medications are most effective when administered early in the course of the illness.

2. Risk of Newborn Chickenpox: The risk of the newborn developing chickenpox is influenced by several factors, including the timing of the mother’s infection relative to delivery. If your wife contracts chickenpox two weeks before delivery, the newborn may be at risk for developing congenital varicella syndrome (CVS) or neonatal varicella. The risk of the newborn developing chickenpox is highest if the mother develops the rash within four days before delivery or up to two days after. However, if the mother has had chickenpox in the past or has been vaccinated, the risk to the newborn is significantly reduced due to the presence of maternal antibodies.

3. Postnatal Treatment and Prevention for the Baby: If the newborn is at risk for chickenpox, healthcare providers may administer varicella-zoster immune globulin (VZIG) within 96 hours of exposure to help prevent or lessen the severity of the disease. Additionally, monitoring the newborn for any signs of chickenpox is crucial, especially in the first few weeks of life. If the baby does develop chickenpox, supportive care, including fever management and hydration, will be necessary. In severe cases, antiviral medications may be indicated.

4. Effects of Infection Two Weeks Before Delivery: The timing of the mother’s chickenpox infection is critical. If the infection occurs two weeks before delivery, the newborn may be at risk for neonatal varicella, which can lead to severe complications, including pneumonia, encephalitis, or even death in some cases. However, if the mother has had chickenpox previously, she may pass on protective antibodies to the baby, which can help mitigate the risk. The newborn should be closely monitored for any signs of infection, and pediatric care should be involved from birth to ensure any necessary interventions are promptly initiated.

In summary, it is crucial for your wife to follow up with her healthcare provider for appropriate management of her chickenpox infection. The healthcare provider can offer tailored advice based on her specific situation, including whether antiviral treatment is necessary. Additionally, close monitoring of the newborn after delivery will be essential to ensure their health and well-being. If you have further concerns, do not hesitate to reach out to a healthcare professional for guidance.

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