Chicken Pox Infections During Pregnancy

QUESTION: I have just learned that I am pregnant and will soon be the mother
of a much desired baby. I have no recollection of ever having chickenpox as a
child, and my physician has warned me about the possible results of an
infection now. I am really worried and wish there was something I could do,
some test I could take to avoid any problems. Can you help me?
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ANSWER: There are many problems that come along with a newborn, and by
staying calm, many problems find solutions that are easier than first thought.
Chickenpox is caused by a virus, the "varicella-zoster virus" (VZV), which is
highly communicable. That probably explains why we find that between 85% to
95% of all young adults living in temperate climates have developed immunity
to the infection. While a history of chickenpox is a reliable indication of
immunity, 75% of adults who have no recollection of ever having had the
disease also display this immunity. A history of shingles would also
indicate that you have an immunity. Unfortunately the test that might predict
your immunity to VZV is not sensitive enough to detect the small amounts that
remain long after the acute infection. The fact is that the subject of the
effect of a VZV infection on a pregnancy is still one of controversy in
medicine. While many authors believe that real risks exist, others cite
studies which do not show a larger number of adverse outcomes after infection.
If they do occur, they don't happen in every case where the mother is
infected, and they are less severe when they occur later in the pregnancy.
Your best defense on behalf of the baby is to stay away from any possibility
of contact with individuals with either chickenpox or shingles. Should you be
exposed to the infection, more than just a casual or brief contact, your
physician might consider the use of varicella-zoster immune globulin, that
could prevent or reduce the severity of your infection. If you did develop a
severe case, treatment with either vidarabine or acyclovir can be used without
danger to the baby. It would seem that both your risks and those of the
infant are quite small, and that there are effective measures that may be
taken should circumstances warrant such action.