Hand, Foot, Mouth Disease - HFMD And Pregnancy

This blog has been receiving hits on exposure to hand, foot and mouth disease (or HFMD) during pregnancy. Specific information on this subject is limited probably due to lack of medical evidence.

Anyway, below are some hinters:

Adults generally were exposed to HFMD during childhood and maintain a natural immunity. Information regarding fetal exposure to HFMD during pregnancy is limited. No solid evidence exists that maternal enterovirus infection is associated with complications such as spontaneous abortion or congenital defects. However, should a baby be born to a mother with active HFMD symptoms, the risk of neonatal infection is high. Typically, such newborns have a mild illness. Rarely, overwhelming infection involving vital organs such as liver, heart, and brain can be lethal.

Some experts also indicated that the risk of contracting hand, foot and mouth disease during pregnancy appears to be small. Although a mother's infection is typically mild, some enterovirus infections can lead to a serious infection in the fetus, congenital abnormalities or, rarely, fetal death.

What if I'm pregnant when my child comes down with the illness? Is the baby I'm carrying at risk?

If you're exposed to HFMD when you're pregnant, the chance that your fetus will be affected is very small, but you should mention it to your ob-gyn. Wash your hands frequently after changing diapers or tending to your sick child's needs. You might also want to consider wearing gloves to keep your risk to a minimum.

How does one manage possible exposure to hand foot and mouth disease in pregnancy?

With reassurance, unless the mother has a febrile illness during the last week of pregnancy.

Pregnancy — Enterovirus infections in pregnant women do not readily cross the placenta and cause fetal disease, nor is there an association with miscarriage or preterm birth. However, rare cases of intrauterine fetal death (from echoviruses or coxsackieviruses) and severe maternal abdominal pain suggestive of abruption have been reported. Vertical transmission is much more likely to occur in the perinatal period. There is no strong evidence that maternal enterovirus infections cause congenital malformation even though a few reports have suggested a possible relationship with certain anomalies.

Neonatal infections — Most newborns with life-threatening enterovirus disease acquire the infection from a symptomatic mother in the perinatal period; approximately 60 to 70 percent of women who bear infected infants have a febrile illness during the last week of pregnancy. Ample experimental evidence indicates that the fetus is relatively protected during maternal infection by the placenta, but the newborn has a high risk of infection, perhaps as a result of exposure to either virus-positive cervical secretions or viremic maternal blood.


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