A tragic case in the United States has highlighted the risks that measles poses to pregnant women. A 21-year-old woman experienced a decline in her health after giving birth at home and ultimately died in the hospital on September 30. Reports indicate that her death certificate listed “suspected measles” as one of the causes. This incident has prompted health experts to emphasize the increased complications that can arise for pregnant women who contract measles, potentially endangering both the mother and the fetus.
In light of a surge in measles cases across Europe and the United States, medical professionals in both regions are urging women of childbearing age to ensure they are vaccinated for measles, mumps, and rubella (MMR) prior to becoming pregnant. This precaution is aimed at mitigating the risks of infection during pregnancy.
On November 4, the Pennsylvania Department of Health confirmed that an unvaccinated resident had died from a measles-related illness. Subsequent reports revealed that the deceased was the aforementioned 21-year-old woman who had given birth at home. Due to complications, she was admitted to the hospital, which underscores the critical nature of prenatal care. Stephanie Nojiri, deputy press secretary of the Pennsylvania Department of Health, verified to ABC News that as of November 6, there had been 97 confirmed cases of measles among pregnant women this year in the state.
Data released by the Centers for Disease Control and Prevention (CDC) on November 6 indicated that there have been 5,182 confirmed cases of measles across the United States this year, marking the highest number since 1991. The CDC has issued warnings that contracting measles during pregnancy can lead to severe complications such as pneumonia, and in severe cases, it can even be fatal. Other potential consequences include miscarriage, preterm birth, and low birth weight in newborns.
Holly W. Cummings, a gynecologist and the chair of the Pennsylvania chapter of the American College of Obstetricians and Gynecologists (ACOG), emphasized the importance of pre-pregnancy health consultations for women to verify their vaccination status. She pointed out that understanding the required health checks and vaccinations prior to conceiving is a crucial aspect of pre-conception care.
Sharee Livingston, an obstetrician at UPMC Magee-Womens Hospital in Pennsylvania, added that medical professionals must closely monitor both the mother’s and fetus’s health if a pregnant woman contracts measles. This close observation is vital, particularly concerning the risks of fetal death and any potential impacts on fetal growth.
Meanwhile, the measles epidemic in the United Kingdom is also seeing a significant resurgence. The World Health Organization (WHO) confirmed in January that the UK had lost its status of measles elimination, attributing this change to a rise in local infection cases. To date, there have been over 1,000 confirmed cases of measles in England, including two fatalities among children. This marks the first time since 2018 that two children in the UK have died from measles in the same year.
Helen Bedford, a professor of child health at Great Ormond Street Hospital in London, noted that pregnant women who contract measles often require hospitalization. She explained that the risk of developing pneumonia and encephalitis after a measles infection is significantly higher among pregnant women. While these complications can also occur in other adults infected with measles, they appear to be more common among pregnant patients.
Bedford further explained that the outcomes of pregnancies involving mothers infected with measles tend to be poorer. Complications can include stillbirth, preterm labor, and low birth weight for the newborn.
The MMR vaccine, typically administered during childhood, is highly effective in preventing measles, mumps, and rubella. After receiving two doses of the vaccine, individuals enjoy about a 97% immunity rate against measles. Those who missed vaccinations during childhood can still catch up on their vaccinations as adults. Bedford emphasized that the MMR vaccine is a live attenuated vaccine and therefore should not be administered during pregnancy. It is recommended that women complete their vaccinations before becoming pregnant. She expressed concern that many women do not plan their pregnancies in advance and may not have regular healthcare visits, often discovering their pregnancy too late to receive the necessary vaccinations.
Currently, there is no effective antiviral treatment for measles. Management of the infection focuses on hydration, fever control, and treating any secondary infections that may arise. The National Health Service (NHS) in the UK advises all women of childbearing age, even those who are not planning to become pregnant, to confirm that they have received two doses of the MMR vaccine to ensure their health and the health of their future children.