Rubella and pregnancy

Rubella, also called German measles, is an infection that causes mild flu-like symptoms and a rash on the skin. Only about half of people infected with rubella have these symptoms. Others have no symptoms and may not even know they’re infected.

Rubella is only harmful to an unborn baby in the womb. If you get infected during pregnancy, rubella can cause serious problems for your baby.

Rubella has been eliminated in the United States because of routine vaccination of children. Vaccination protects a person against rubella for life. Only five cases of rubella were reported in this country between 2001 and 2004. But women who were never vaccinated as children can get infected.

Rubella is common in many other countries. Travelers can bring it into the United States, or you can get it when travelling outside the country.

It’s important to get vaccinated for rubella. Talk to your health care provider to make sure you’re protected against it.

What are signs and symptoms of rubella?
About half of people with rubella have signs and symptoms, and half don’t. Rubella is usually mild with flu-like symptoms followed by a rash. The rash often lasts about 3 days. Flu-like symptoms include:

  • Low-grade fever
  • Headache
  • Runny nose
  • Red eyes
  • Swollen glands
  • Muscle or joint pain

What causes rubella?
Rubella is caused by a virus (a tiny organism that can make you sick). It’s very contagious and is spread through the air from an infected person’s cough or sneeze.

What problems can rubella cause during pregnancy?
Rubella can be a serious threat to your pregnancy, especially during the first and second trimesters. Having rubella during pregnancy increases the risk of:

  • Congenital rubella syndrome (CRS) – This is a condition that happens when a mother passes rubella to her baby during pregnancy. It may cause a baby to be born with one or more birth defects, including heart problems, vision problems, hearing problems, intellectual disability, bone problems, growth problems, and liver and spleen damage.
  • Miscarriage – This is when a baby dies in the womb before 20 weeks of pregnancy.
  • Stillbirth – This is when a baby dies in the womb after 20 weeks of pregnancy.
  • Premature birth – This is birth that happens too early, before 37 completed weeks of pregnancy.

Can you pass rubella to your baby during pregnancy?
Yes. The best way to protect your baby is to make sure you’re immune to rubella. Immune means being protected from an infection. If you're immune to an infection, it means you can't get the infection.

Most likely you’re immune to rubella because you were vaccinated as a child or you had the illness during childhood. A blood test can tell whether or not you’re immune to rubella. If you’re thinking about getting pregnant and aren’t sure if you’re immune, talk to your health care provider about getting a blood test.

If you’re not immune to rubella, here’s what you can do to help protect your baby:

Before pregnancy. Get the measles, mumps and rubella (MMR) vaccine. Wait 1 month before trying to get pregnant after getting the shot.

During pregnancy. You can be tested at a prenatal visit to make sure you’re immune to rubella. If you’re not immune, the MMR vaccine isn’t recommended during pregnancy. But there are things you can do to help prevent getting infected with rubella:

  • Stay away from anyone who has the infection.
  • Tell your health care provider right away if you’ve been in contact with someone who has rubella.

After pregnancy. Get the MMR vaccination after you give birth. Being protected from the infection means you can’t pass it to your baby before she gets her own MMR vaccination at about 12 months. It also prevents you from passing rubella to your baby during a future pregnancy.

What are the chances of passing rubella to your baby during pregnancy?
You’re more likely to pass rubella to your baby the earlier you become infected during pregnancy. For example:

  • If you get rubella in the first 12 weeks of pregnancy, your baby has about an 8 to 9 in 10 chance (85 percent) of getting infected.
  • If you get rubella at 13 to 16 weeks of pregnancy, your baby has about a 1 in 2 chance (50 percent) of being infected.
  • If you get rubella at the end or your second trimester or later, your baby has about a 1 in 4 chance (25 percent) of getting infected.

If you have rubella during pregnancy, your baby’s provider carefully monitors your baby after birth to catch any problems early.

Last reviewed March 2012

See also: Rubella and your baby, Vaccinations and pregnancy

Most common questions

What is mononucleosis?

Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.

You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:

  • Achy muscles
  • Belly pain
  • Fatigue (feeling tired all the time)
  • Fever
  • Sore throat
  • Swollen glands in your neck

If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.

There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.

Can Rh factor affect my baby?

The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.

If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.

If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.

I had a miscarriage. How long should I wait to try again?

Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.

Are gallstones common during pregnancy?

Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).