He said the CDC is aware of one pregnant woman in the United States who was confirmed to have mpox 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 Mpox
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 mpox be in pregnancy? There have been reports of pregnancy loss and stillbirth in people confirmed to have mpox. Dr. Kuritzkes noted that there are not many well-documented cases of mpox 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 mpox 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 mpox 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 Mpox Be Passed to the Fetus?
In the one U.S. case reported to the CDC, the mother’s mpox 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 mpox isn’t transmitted to a fetus in the womb, the baby could be infected during delivery if the parent has a rash. The virus spreads via direct contact with mpox 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 Mpox in Pregnant People
Mpox’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:
FeverHeadacheMuscle aches and backacheSwollen lymph nodesChillsExhaustionRespiratory 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 Mpox?
Right now, there is only one drug considered safe to treat mpox 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 Mpox?
Dr. Kuritzkes said of the two vaccines being used in the U.S. to prevent mpox—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 mpox.
For Most People, Risk of Infection is Low
The thought of having mpox 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 mpox 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.”
