What you need to know about mpox and pregnancy

If you’re pregnant, you may be wondering what the World Health Organization’s most recent declaration about mpox could mean for you and your baby on the way.

While the risk to the U.S. continues to be low, there are some things we know about mpox and pregnancy that will help you understand more about the disease and how to protect your family.

How does mpox affect pregnant people?

We have little information about how mpox, also known as monkeypox, affects pregnant people. It’s unknown if pregnant people are more likely to get mpox than people who aren’t pregnant or if mpox causes more serious disease during pregnancy. However, smallpox, a now-eradicated virus in the same family as mpox, can cause severe disease in pregnancy, as well as poor birthing outcomes.

How does mpox affect developing fetuses and newborns?

The federal Centers for Disease Control and Prevention (CDC) reports that the virus can be passed to a developing fetus or to a newborn baby during or after birth.

There have been reports of pregnant people with mpox having miscarriages or stillbirths or giving birth prematurely, but it’s unknown how common these outcomes are.

What’s the risk for mpox in the United States?

The World Health Organization declared a public health emergency of international concern in August 2024 due to an outbreak of mpox in the Democratic Republic of the Congo and nearby countries. There’s concern the outbreak could continue to spread across Africa and possibly to other continents.

The CDC reports that no known cases of mpox linked to the current outbreak have been found in the United States, and the agency currently considers the risk to the general public in the U.S. to be low.

This follows a 2022 global outbreak that led to more than 95,000 cases in 115 countries, including Europe and North America — continents that don’t typically see mpox. About 33,000 cases and 60 deaths occurred in the U.S.

Prior to the 2022 outbreak, the U.S. had experienced an mpox outbreak in 2003, with 47 confirmed cases in six states: Illinois, Indiana, Kansas, Missouri, Ohio and Wisconsin. The cases were linked to infected pet prairie dogs imported from Africa.

What are the signs of mpox?

Mpox usually starts with fever or chills, fatigue, headache, muscle aches, swollen lymph nodes, congestion and a cough.

Mpox also causes a rash on the hands, feet, chest, face, mouth or near the genitals. This usually starts about one to four days after the other symptoms. The rash can last for two to four weeks. The rash can be mistaken for other common conditions, such as pruritic urticarial papules and placques of pregnancy (PUPPs).

Can I get treated for mpox while pregnant?

Most people with mpox have a mild illness that goes away on its own. However, your doctor may want to treat you due to the possible risk of severe illness during pregnancy or of passing the virus to the fetus or newborn.

While there are no specific treatments for mpox, the CDC recommends considering the antiviral drug called tecovirimat, which can be used in people who are pregnant and breastfeeding. We do not know if taking tecovirimat prevents viral transmission to the baby.

Tecovirimat is not readily available to treat patients. Pregnant people may receive treatment in one of two ways: through a research protocol from the National Institute of Allergy and Infectious Diseases or through an expanded investigational new drug protocol from the CDC.

If necessary, your doctor will discuss with you the risks and benefits of this treatment and other possible options.

Can pregnant people get an mpox vaccine?

The U.S. Food and Drug Administration has approved the Jynneos vaccine for people at high risk of mpox, including people who are pregnant.

However, there isn’t enough data on humans to determine if there are any risks to pregnancy associated with the vaccine, so it’s important to discuss benefits and risks with your doctor. Animal studies have shown no evidence that the vaccine harms a developing fetus.

There is also no evidence on the impact of the vaccine on breastmilk, but the CDC says it is unlikely to be passed to infants in breastmilk.

How can I avoid mpox in pregnancy?

The virus is spread through close or intimate contact with the rash, scabs or body fluids. It’s important to use caution around anyone showing these signs and to stay away from infected individuals until all lesions have scabbed over and a fresh layer of skin has formed.

• Avoid close contact with anyone who has symptoms of mpox, including skin or genital lesions.
• Avoid contact with contaminated materials used by sick people.
• Avoid contact with live or dead wild animals in areas where mpox regularly occurs.
• Avoid contact with materials that came into contact with wild animals.
• Avoid eating or preparing meat from wild animals or using products derived from wild animals.

Pregnant people should notify their providers as soon as possible if they have a confirmed contact exposure or if they develop the characteristic rash. Treatment is best started within 14 days, and within four days is better. Pregnant people with a confirmed contact exposure need to monitor for signs and symptoms for 21 days.

How can I prevent passing mpox to my newborn?

Newborns potentially risk severe disease if infected with mpox. If you have mpox, it’s recommended you stay in separate rooms. If that’s not possible, patients should:

• Avoid direct skin-to-skin contact.
• Fully cloth or swaddle the newborn during contact, removing and replacing the garments immediately afterward.
• Wear clean gloves and gown, covering all skin below the neck.
• Wear a well-fitting medical mask.
• Remove soiled linens.