What Pregnant People Need to Know About Monkeypox

pregnant isolation

As if expectant parents don’t have enough to worry about, particularly after surviving a pandemic, yet another virus has emerged from the shadows to wreak havoc on the mental health of anxious new parents everywhere: Monkeypox.

The monkeypox virus belongs to the same family of viruses as the virus that causes smallpox. According to the CDC (Center for Disease Control), monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. 

Currently there are over 21,000 cases in the United States and over 57,000 cases worldwide. While the name sounds scary, monkeypox is rarely fatal and many cases are mild.

We spoke to Dr. Daniel Roshan, a high-risk maternal-fetal OBGYN in NYC, about what pregnant people need to know as cases of monkeypox continue to rise. 

Are pregnant people at a higher risk of developing a severe case of monkeypox? 

While pregnant people do have weakened immune systems, they are not necessarily at a higher risk for severe monkeypox infection. Though, precautions to avoid exposure and subsequent infection is paramount.

What signs/symptoms of monkeypox should expectant parents look for? 

In most cases, monkeypox has a prodromal phase where symptoms are similar to that of a cold or other viral illness and last for about 5 days. Incubation time is varied but usually within 5-7 days post infection, a rash will appear, typically in clusters on hands or face and should be evaluated by a healthcare professional urgently. 

How can pregnant people protect themselves from infection?  

Frequent handwashing, avoiding contacts with possible or known exposure and diligence to avoid areas of high infection rates can help pregnant people to avoid exposure and infection with monkeypox.

What should pregnant people do if symptoms of monkeypox develop?

If a pregnant person develops viral illness symptoms such as fever, fatigue, general malaise and or an unexplained rash, they should be evaluated by an OB or closest healthcare provider emergently. If infection is confirmed, subsequent instructions including isolation and very close fetal monitoring will be advised by maternal-fetal medicine.

What are the potential complications that can result from contracting monkeypox while pregnant?

Monkeypox in pregnancy is very uncommon and so far only one confirmed case in the US. In the Democratic Republic of Congo where the virus originated, there are 4 known cases of monkeypox in pregnancy. Of those four confirmed cases, two were moderate cases and resulted in early miscarriage, one in fetal death at 21 weeks in which the fetus appeared severely infected and the other was a mild case at 14 weeks, carried to term a healthy baby.

Can the monkeypox virus be transferred from mom to baby? How does monkeypox affect unborn and newborn babies?

Monkeypox can be transferred from mother to baby through the placenta though this does not always happen and transmission rate and risk at each trimester is unknown. It can affect unborn babies if it is passed through the placenta and can result in death of the fetus. The disease can also be passed to a neonate from the mother at delivery or through breastfeeding. Mode of delivery and clearance for nursing will be given by OB and MFM. 

How can parents protect their families, young children in particular, from contracting the virus?

Again, frequent handwashing and avoiding contact with anyone who is sick or has a rash of unknown cause is critical to prevent exposure and monkeypox infection.

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