Viral Infections in Pregnancy: Causes, Risks, and Prevention Tips

Being unwell at a time when your baby’s health is of prime importance isn’t a great feeling at all. Your good health is critical to ensure a safe and stress-free pregnancy. Fortunately, modern vaccination programs and advanced medications ensure that you are immune to many contagious diseases. Of course, it is not possible to avoid infections completely during pregnancy, but precautions can surely be taken to keep them away, and that is possible only if you have the awareness. In this post, we talk about some common viral infections in pregnancy that pregnant women need to safeguard themselves from. Let’s first understand how viral infections could affect pregnancy.

Viral Infections and Pregnancy

During pregnancy, it becomes imperative to know the kinds of infections that can make you sick. Since this makes the baby vulnerable to the infections too, prenatal care becomes quite critical during this period. Further complications can be avoided by getting necessary medical attention if you feel you have been exposed to an infection, serious or otherwise.

Common Viral Infections While Pregnant

Pregnancy can make women more vulnerable to certain infections due to changes in the immune system. While some infections may cause only mild symptoms in the mother, others can affect the baby’s growth and development if left untreated. Below are some of the most common viral infection in pregnancy.

1. Bacterial Vaginosis

Generally known as BV, bacterial vaginosis is caused due to an imbalance in the bacteria in the vagina. The bacteria consists of good bacteria, known as lactobacilli, and help in controlling various other bacteria. This disparity happens when lactobacilli reduce in quantity, thus allowing other bacteria to grow uncontrollably. However, the reasons for this imbalance are unknown (1).

Generally, there are no symptoms of BV, but in some cases, the woman may experience a thin white, foul-smelling discharge. At such times, you can inform your doctor about it, so samples of vaginal secretions can be taken and tested for BV or any other infection. Also, you pregnant women must follow safe sex practices, quit smoking and refrain from douching or using soaps around the genital area to prevent bacterial vaginosis.

Impact on Baby:

If left untreated during pregnancy, bacterial vaginosis may increase the risk of premature birth, low birth weight, and early rupture of membranes. In some cases, the infection may also increase the chances of uterine infection after delivery (2). Early diagnosis and treatment can help reduce these risks significantly.

2. Chikungunya

This viral infection is caused by the bite of a certain kind of mosquito. This mosquito-borne illness can prove to be dangerous to pregnant women and their babies if left untreated. Chikungunya virus can be transferred from the mother to her baby at the time of delivery, too.

Chikungunya patients show symptoms of pain or swelling in joints, fever, headache, muscle pain and rash. Getting rest and drinking lots of water is the only way of treating the infection. Your doctor may also prescribe medication to relieve joint pain and fever. Wear clothing that covers your entire body, and make liberal use of pregnancy-safe mosquito repellents to prevent chikungunya (3).

Impact on Baby:

If the infection occurs close to the time of delivery, the virus may pass on to the newborn and cause fever, poor feeding, skin problems, or neurological complications. In severe cases, babies may require intensive medical care (4). Although birth defects are uncommon, maternal infection can increase pregnancy-related complications if not monitored properly.

3. Urinary Tract Infection

Also known as UTI, it is a common infection that affects pregnant women. UTI can affect any part of the urinary tract and can go beyond the bladder. It can be caused by the bacteria present around the vagina, rectum, or on the skin around it. The bacteria travel upstream and enter into the urethra, thus causing the infection, which could also lead to (5):

• Kidney infection: Bacteria from the bladder could move up the ureters and infect one or both the kidneys and can prove to be a serious complication when it occurs during pregnancy. High fever, vomiting, nausea, and pain in the abdomen or lower back are its common symptoms.
• Asymptomatic bacteriuria: The bacteria remain in the urinary tract and the pregnant woman wouldn’t show any symptoms. However, if it is not diagnosed and is left untreated, it could pave the way for a kidney infection.
• Cystitis or bladder infection: The bacteria that remain inside the bladder can multiply and cause inflammation. Pain or burning during urination or sexual intercourse and lower abdominal pain are noticeable symptoms of cystitis.

Impact on Baby:

Untreated UTIs during pregnancy can increase the risk of premature labour, low birth weight, and infection in the newborn. Severe kidney infections in the mother may also reduce fetal growth and increase the likelihood of pregnancy complications. Prompt treatment with pregnancy-safe antibiotics is important to protect both mother and baby (6).

4. Hepatitis B

When you are pregnant, your doctor will get you checked for hepatitis B virus during the first prenatal visit itself. This virus is known to cause liver damage and extreme illness and can be life-threatening, too. If you are infected with it during pregnancy, this virus can be passed on to the baby at birth.

This infectious virus spreads through the exchange of blood, semen, and other body fluids. Do not share needles, razors or toothbrushes where there is a possibility of blood (7). Also, avoid getting tattoos or piercing done at places that are unhygienic and unkempt.

Impact on Baby:

Babies infected with hepatitis B during birth have a high risk of developing chronic liver disease later in life. This can lead to liver damage, cirrhosis, or liver cancer in adulthood. However, timely vaccination and hepatitis B immunoglobulin given to the baby soon after birth can greatly reduce the risk of transmission (8).

5. HIV

HIV is the acronym for human immunodeficiency virus which destroys the body’s ability to fight infections in a gradual manner, by attacking its immune system. Unless treated in its early stages, HIV can prove to be fatal when it develops in AIDS (Acquired Immunodeficiency Syndrome).

You could get infected by HIV by having unprotected sex with an HIV positive partner or through the exchange of blood, semen or vaginal fluids. There are no symptoms initially for some, while some can develop flu-like symptoms (9). You should get checked for HIV when you are pregnant. If you test positive for HIV, treatment can begin to prevent the virus from spreading to your baby.

Impact on Baby:

Without treatment, HIV can pass from the mother to the baby during pregnancy, childbirth, or breastfeeding. Babies infected with HIV may develop severe infections, poor growth, and long-term immune system problems. With proper antiretroviral treatment during pregnancy and after birth, the risk of transmission can be reduced significantly (10).

6. Cytomegalovirus

Commonly known as CMV, this is a virus from the herpes family and is often passed on to the baby during pregnancy. The baby could be extremely ill at birth, face many long-term issues immediately, and could also develop complications like reduced vision or hearing loss after many months or years. CMV virus can remain dormant in your body for years and can reappear when your immune system is low, like during pregnancy (11).

This viral infection can pass on to your baby during a first-time pregnancy, and hence it is important to check for its presence. If the doctor finds CMV related signs during your ultrasound, or if you develop symptoms, he/she may suggest necessary tests. CMV spreads through sexual contact, mouth-to-mouth kissing or by coming into direct contact with an infected person’s saliva, urine, faeces, or tears.

Impact on Baby:

CMV infection during pregnancy may lead to hearing loss, vision problems, seizures, developmental delays, or learning disabilities in the baby. Some babies may appear healthy at birth but develop complications months or years later. Severe infections can also result in low birth weight or premature delivery (12).

7. Chicken Pox

The virus, varicella-zoster, is responsible for spreading this viral infection. If you contract this viral infection in early pregnancy or during the first trimester, you run the risk of passing it through the placenta on to your baby.

If you are not immune to chicken pox, avoid being around anyone who has contracted this disease. Anyone who has flu-like symptoms could be infected with chicken pox and can be contagious even before the rash begins to show on the body (13). Do not get the chicken pox vaccine while you are pregnant and wait for a month after the vaccine before trying to conceive.

Impact on Baby:

Chicken pox during pregnancy can cause congenital varicella syndrome, especially if infection occurs during the first or early second trimester. This may result in birth defects affecting the limbs, eyes, brain, and skin. If the mother develops chicken pox close to delivery, the newborn may develop severe neonatal chicken pox, which can be life-threatening without prompt treatment (14).

How to Prevent Viral Infections in Pregnancy?

While not all infections can be avoided completely, following proper hygiene practices and taking preventive measures can greatly reduce the risk and help protect both the mother and the baby (15).

• Wash your hands frequently with soap and water, especially after using the restroom, handling raw food, or coming in contact with sick individuals.
• Stay away from individuals who have contagious illnesses such as chicken pox, flu, or viral fever to minimise the risk of transmission.
• Using protection and limiting exposure to infected bodily fluids can help prevent sexually transmitted infections such as HIV and hepatitis B.
• Speak to your doctor about vaccines that are safe and recommended before or during pregnancy, such as the flu vaccine and hepatitis B vaccine.
• Wear full-sleeved clothing, use pregnancy-safe mosquito repellents, and avoid stagnant water areas to reduce the risk of mosquito-borne infections like chikungunya.
• Avoid douching or using harsh soaps around the genital area, as this can disturb the natural balance of bacteria and increase the risk of infections.

FAQs

1. Are viral infections common in pregnancy?

Yes, mild viral infections like flu or common cold are quite common during pregnancy. However, some infections such as CMV, chickenpox, or hepatitis B are less common but can be more serious.

2. Can viral infections cause miscarriage?

Some severe viral infections, especially if left untreated in early pregnancy, may increase the risk of miscarriage. The risk depends on the type of virus and the severity of infection.

3. How long do viral infections usually last during pregnancy?

Most mild viral infections like cold or flu last about 5-10 days. However, recovery time may be slightly longer in pregnancy due to a naturally weaker immune response.

Your child could suffer due to the infections you have, and it is best to prevent them by taking the necessary precautions. Do not ignore any such infection during or before pregnancy as it could cause irreparable damage to your baby if left untreated.

Also Read: 

Maternal Sepsis
Infections that affect Pregnancy
Vaginal Infections during Pregnancy
Pelvic Inflammatory Diseases (PID)

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Sources References

1. Cleveland Clinic – Bacterial Vaginosis

2. March of Dimes – Bacterial vaginosis and pregnancy

3. WHO – Chikungunya

4. PubMed Central – Chikungunya infection in pregnancy – reassuring maternal and perinatal outcomes: a retrospective observational study

5. Cleveland Clinic – Urinary Tract Infections

6. National Library of Medicine – Urinary Tract Infection in Pregnancy

7. Cleveland Clinic – Hepatitis B

8. American College of Obstetricians and Gynecologists – Viral Hepatitis in Pregnancy

9. WHO – HIV and AIDS

10. American College of Obstetricians and Gynecologists – HIV and Pregnancy

11. Cleveland Clinic – Cytomegalovirus (CMV)

12. March of Dimes – Cytomegalovirus and pregnancy

13. National Centre for Infectious Diseases – Chickenpox

14. PubMed Central – CHICKEN POX IN PREGNANCY : AN OBSTETRIC CONCERN

15. American Academy of Pediatrics – 10 Simple Steps to Prevent Infections During Pregnancy