chickenpox in pregnancy

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  • chickenpox occurs in pregnancy in about 3 per 1000 women in the UK
  • about 90% of women have antibodies to varicella zoster virus - VZV - and therefore the fetus is not at risk of chickenpox even of the mother develops shingles during pregnancy (1)
  • in the nonimmune pregnant woman, chickenpox is a potentially dangerous disease associated with fetal and maternal morbidity and mortality (1)
    • chickenpox infection in pregnant women can lead to to varicella pneumonitis and severe maternal illness and it appears five times more likely to be fatal than in non-pregnant women (2,3)
      • the risk is higher after 20weeks of gestations in; those who smoke, have chronic lung disease, are immmunosupressed, or have more than 100 skin lesions (3)
      • pneumonia is seen in up to 10% of  pregnant women with chickenpox and appears to increase in severity with later gestation (4)
    • although most women who have chickenpox in pregnancy give birth to healthy children, in other cases, the baby is harmed by in-utero infection or severe varicella of the newborn (2)
      • fetal varicella syndrome syndrome is a known complication in the first half of the pregnancy  (4)
        • risk of the syndrome in children exposed to chickenpox in utero is around 0.5% if maternal chickenpox develops at 2-12 weeks of pregnancy
        • 1.4% if it develops at 12-28 weeks
        • 0% if it develops from 28 weeks onwards
        • overall risk in the first 20 weeks of pregnancy is 0.91%
    • shingles in a pregnant woman does not pose a risk to the infant (3)

Reference:

Last reviewed 01/2018

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