What we know about monkeypox in pregnancy, including treatment recommendations, vaccination, and postpartum care.
Providers should prioritize currently or recently pregnant and breastfeeding people with monkeypox infection for medical treatment before non-pregnant individuals, as the likely increased risk of severe disease, fetal transmission during pregnancy, and severe newborn infection via close contact during and after birth.
While they are considered alternative antiviral therapies for treating monkeypox infection, animal studies have shown evidence of teratogenicity so they should not be used to treat people in their first trimester of pregnancy. Their presence in breastmilk is also unknown, so it should also be avoided in breastfeeding people in case of serious adverse reactions in the breastfeeding infant.
Researchers have not yet conducted animal reproduction studies with VIVIG, so there is little data on whether it can cause fetal harm during pregnancy, or on a person’s future fertility. However, immune globolins have been used during pregnancy for many years without any apparent negative reproductive side effects. Providers should evaluate the risks and benefits of VIVIG for each individual patient and exercise caution when administering to a breastfeeding person, as it may be excreted in breast milk.
Replicating viral vaccine licensed for smallpox prevention. Contraindicated in pregnant and breastfeeding people due to risk of pregnancy loss, congenital defects, and fetal-infant vaccinia virus infection.
CDC. Clinical Considerations for Monkeypox in People Who are Pregnant or Breastfeeding. Centers for Disease Control and Prevention. Published July 18, 2022. Accessed July 26, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/pregnancy.html