- A pregnant woman with monkeypox gave birth, the first reported case in the United States. The baby was not infected and both are healthy.
- Monkeypox can spread to a fetus during pregnancy or delivery.
- Pregnant people in the United States are at a low risk of exposure to monkeypox right now, experts say.
As the monkeypox outbreak unfolds, reports have emerged of a U.S. woman who tested positive while pregnant and gave birth to a healthy baby. On July 23, in a panel discussing updates on monkeypox testing and treatment for the Infectious Diseases Society of America, John Brooks, MD, chief medical officer for the Centers for Disease Control and Prevention’s (CDC) Division of HIV Prevention, shared further details.
He said the CDC is aware of one pregnant woman in the United States who was confirmed to have monkeypox and has delivered a baby. While it is possible for the virus to spread to a fetus via the placenta, that did not happen in this case, he reported. Both mother and baby are healthy.
On the heels of the COVID-19 pandemic, news of another virus can be understandably troubling, especially for pregnant people. When guidance about treatments and vaccines comes out, it can leave people wondering which recommendations apply to them and how they can stay safe.
Risks for Pregnant People With Monkeypox
Viral illnesses tend to affect pregnant people more severely than the general population, said Daniel Kuritzkes, MD, the chief of infectious diseases at Brigham and Women’s Hospital in Boston.
“The concern is that, especially later in pregnancy, people’s immune systems are relatively suppressed, and many viral infections can be more severe. For example, chickenpox can be quite severe in late-term pregnancy.”
So, how serious can monkeypox be in pregnancy? There have been reports of pregnancy loss and stillbirth in people confirmed to have monkeypox. Dr. Kuritzkes noted that there are not many well-documented cases of monkeypox in pregnant women, but referenced one 2017 report that shed light on some potential effects of the infection.
“There’s a report of four cases of monkeypox in pregnant women that showed there can be serious adverse outcomes,” he said. “In one instance, there was a premature stillbirth of the fetus. A postmortem examination showed there had been spread of monkeypox to the fetus, with visible lesions on the body and infection of the liver. Two of the women miscarried much earlier in pregnancy, and the last one had no adverse outcome.”
Can Monkeypox Be Passed to the Fetus?
In the one U.S. case reported to the CDC, the mother’s monkeypox infection did not spread to her baby. That said, both the CDC and Dr. Kuritzkes agree that it is possible for the virus to pass from mother to fetus.
The CDC states, “A pregnant person can spread the virus to their fetus through the placenta.”
Dr. Kuritzkes added that even if monkeypox isn’t transmitted to a fetus in the womb, they could be infected during delivery if the parent has a rash. The virus spreads via direct contact with monkeypox sores or scabs.
“Depending on what lesions might be present at the time of delivery, if there are lesions on the vulva, you’d expect there could be postnatal transmission,” he said.
Symptoms of Monkeypox in Pregnant People
Monkeypox’s best known symptom is a rash that looks similar to blisters or pimples, and can cause itching or pain. It typically appears on or around the genitals or anus, but has been seen elsewhere on the body too, like the mouth, face, chest, hands, and feet.
According to the CDC, other symptoms include:
- Muscle aches and backache
- Swollen lymph nodes
- Respiratory symptoms such as sore throat, nasal congestion, or cough
Pregnant people should be on the lookout for the same symptoms, and call their healthcare provider if they have any concerns.
“I wouldn’t expect the symptoms to be any different,” Dr. Kuritzkes said. “The virus will behave in the same way: it’s going to cause fever, fatigue, skin rash.”
What Is the Treatment for Monkeypox?
Right now, there is only one drug considered safe to treat monkeypox in pregnant people: TPOXX (tecovirimat). According to the CDC, the only data available about its use in pregnancy comes from animal studies.
“It could be used to treat pregnant women cautiously,” said Dr. Kuritzkes. “If a woman was pregnant and became infected, she and her providers would need to discuss the potential risks and benefits given that we have little information about its safety in pregnancy, or effectiveness in preventing mother-to-child transmission.”
Can Pregnant People Be Vaccinated for Monkeypox?
Dr. Kuritzkes said of the two vaccines being used in the U.S. to prevent monkeypox—ACAM2000 and JYNNEOS—only the latter could be considered safe for pregnant people, though human data is limited. ACAM2000 is not recommended due to risk of pregnancy loss, congenital defects, and other adverse effects, per the CDC.
Aside from getting vaccinated, the CDC recommends regular handwashing and avoiding close contact with people who have a rash that looks like monkeypox.
For Most People, Risk of Infection is Low
The thought of having monkeypox while pregnant is scary, but experts want people to know it’s still a rare infection.
“People who are pregnant are at an extraordinarily low risk of acquiring monkeypox right now in the United States because transmission has been almost exclusively among men who have had sex with men,” said Dr. Kuritzkes. “Somebody who is pregnant and having multiple sex partners might be at risk, but if you’re not having multiple sex partners, that is much less likely. It’s not something that most people need to be worried about.”
What This Means For You
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