Acute Illnesses During Pregnancy
- Some illnesses that are normally harmless can pose an increased risk to the mother or the unborn baby during pregnancy.
- Most infectious diseases can be treated effectively during pregnancy. Treatment can relieve symptoms and reduce the risk of transmission to the unborn baby.
- Sexually transmitted infections are understandably a sensitive topic for many people. During pregnancy, however, it is especially important to speak to a doctor if you have questions or are experiencing specific symptoms.
What Should You Know About Infectious Diseases During Pregnancy?
Pregnancy changes the immune system. On the one hand, this helps protect both mother and baby; on the other hand, it can make them more susceptible to certain illnesses.
Because some infectious diseases may pose a risk to the unborn baby, it is advisable to discuss any unusual symptoms or concerns with an appropriate healthcare professional as soon as possible and have them assessed.
Some tests for common infections, such as rubella, are included in routine antenatal care – even if there are no specific symptoms. Tests for other conditions, however, are usually only covered by health insurance when there is a specific reason to suspect an infection.
You can also request a test yourself and pay for it privately. Costs vary depending on the test, but they are often less than €30. Some clinics and health centres offer free testing for sexually transmitted infections.
If you have already tested positive for a particular infection, physical symptoms are often accompanied by concerns and questions. Many women wonder: Can the infection be passed on to my baby during pregnancy? In the case of sexually transmitted infections, another common question may be: How did I become infected?
You may also be worried by certain symptoms because it is difficult to know what they mean, leaving you wondering: Am I pregnant, or could these symptoms indicate an illness or infection?
You can read more about this here: Signs of Pregnancy
ℹ️ Some illnesses may be unpleasant, but they usually clear up on their own. Others should be treated or carefully monitored, particularly during pregnancy, as they may pose an increased risk to the mother and/or baby.
Below, we have summarised some common infectious diseases and provide guidance on what to look out for during pregnancy.
Chlamydia
What Is Chlamydia?
Chlamydia is a bacterial infection that can affect the mucous membranes of the eyes, respiratory tract, and genital area. Chlamydia infection is one of the most common sexually transmitted infections (STIs).
When symptoms do occur, they may include pain when passing urine, yellowish discharge, vaginal itching, and other (often non-specific) lower abdominal symptoms. In severe cases, a chlamydia infection can lead to infertility in women if it causes inflammation and scarring of the fallopian tubes. For this reason, chlamydia should be treated once it has been diagnosed. In many cases, however, the infection goes unnoticed because it causes no symptoms. It may also clear up on its own without treatment.
Chlamydia Infection During Pregnancy – Can It Be Passed to the Baby?
Testing for chlamydia is part of routine antenatal screening during the first weeks of pregnancy and is covered by health insurance.
If the infection is left untreated in the mother, it can lead to inflammation of the ovaries and fallopian tubes. It also increases the risk of miscarriage or premature rupture of membranes.
The baby can become infected during childbirth. If the infection is not treated, around 60–70% of babies become infected through transmission in the birth canal.
A chlamydia infection in a newborn can cause eye infections, middle ear infections, or pneumonia. For this reason, it should be treated as early as possible during pregnancy to help prevent transmission during birth.
Treatment of a Chlamydia Infection
A chlamydia infection should be treated with antibiotics as soon as possible. Which antibiotic can be taken and at what stage of pregnancy should be discussed with a doctor.
It is important that the partner is also treated – regardless of whether they have symptoms or not – to prevent reinfection between partners.
Genital Warts (HPV)
What Are Genital Warts?
Genital warts are a sexually transmitted infection (STI). They are also known as condylomata or genital warts because they most commonly appear on the external genital area.
They are caused by human papillomaviruses (HPV), which infect the skin and alter skin cells, leading to benign skin growths that develop into warts. These warts are generally harmless. Genital warts can be uncomfortable and may cause itching, but they are usually not painful.
Most HPV infections go unnoticed because the immune system is often able to fight off the virus. Many people never develop visible warts, although they can still transmit the virus to others. In other cases, the characteristic skin changes appear sooner or later.
Some HPV types – particularly HPV 16 and HPV 18 – can cause cellular changes that may lead to cancer, including cervical cancer in women. When detected early, these cellular changes can usually be treated successfully.
Genital Warts During Pregnancy – Can They Be Passed to the Baby?
According to current medical knowledge, genital warts during pregnancy are not dangerous to the unborn baby. Transmission of HPV to the baby during birth is theoretically possible, but it occurs only very rarely. If a large number of warts develop in the genital area, treatment may be necessary. In consultation with a doctor, treatment is usually best scheduled towards the end of pregnancy – but not immediately before birth – to allow the skin time to heal.
Treatment of Genital Warts
Genital warts can be treated either with prescription topical creams or removed through a minor medical procedure (such as surgical removal, cauterisation, or cryotherapy). Both treatment options are generally possible during pregnancy.
Without treatment, the warts usually remain present, although in some cases they may disappear on their own.
Genital Herpes
What Is Genital Herpes?
Genital herpes (Latin: Herpes genitalis) is a viral infection caused by herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2).
Both viruses are mainly transmitted through contact with herpes blisters. Most people become infected with HSV-1 during childhood.
HSV-2, on the other hand, is the type most commonly responsible for genital herpes. This type of herpes virus is primarily transmitted through sexual contact and is therefore classified as a sexually transmitted infection (STI).
In many cases, the infection causes no symptoms. However, if the immune system is weakened, a herpes outbreak may occur, leading to itchy, painful, and weeping blisters in the genital area. Other symptoms may include vaginal discharge, fever, headaches, muscle aches, and swollen lymph nodes in the groin.
Herpes viruses remain in the body for life after infection, which can lead to further outbreaks. These outbreaks usually become less frequent and less severe over time as the immune system helps keep the virus under control.
Genital Herpes During Pregnancy – Can It Be Passed to the Baby?
During pregnancy, a distinction is made between a first outbreak (primary infection) and a recurrence of a previous herpes infection (reactivation).
A herpes infection can be transmitted to the (unborn) baby. However, transmission is much less common when a previous infection reactivates than when a woman becomes infected for the first time during pregnancy.
A type 2 infection poses a greater risk to the baby than a type 1 infection.
Because genital herpes does not always cause clear symptoms, it is advisable during pregnancy to have any unusual changes to the skin in the genital area assessed by a healthcare professional.
A caesarean section is usually recommended only if a woman experiences a herpes outbreak shortly before giving birth, as there is a risk that the baby could become infected during a vaginal delivery.
In babies, infection typically appears as a blistering rash. In the most severe cases, infection in a newborn can become life-threatening and may lead to seizures, meningitis, or respiratory failure. For this reason, a baby will be treated with antiviral medication if there is reason to suspect infection after birth.
Breastfeeding is usually not a problem if the mother has a herpes infection. However, care should be taken if there are weeping blisters around the mouth, as the baby could become infected through direct contact.
Treatment of (Genital) Herpes Infection
Testing for herpes is not part of routine antenatal care. However, if a pregnant woman has symptoms that may indicate herpes, the test is usually covered by health insurance. Some clinics and health centres also offer free genital herpes testing as part of screening for sexually transmitted infections, even if no symptoms are present.
To diagnose genital herpes, a doctor will usually take a swab. This allows the exact type of virus to be identified. A blood test may also provide evidence of antibodies. Treatment depends on the type of herpes virus involved and the stage of pregnancy.
A first genital herpes infection is usually treated with antiviral medication. This helps relieve symptoms and also reduces the risk of transmission to the baby during birth. As treatment recommendations vary depending on the individual situation, and not all medications are suitable during pregnancy, good medical advice is important. As with all sexually transmitted infections, it is advisable to involve the partner in treatment as well.
Particularly during the final trimester of pregnancy, it is important to try to avoid a first herpes infection. Women who know they have had a previous herpes infection and are planning a pregnancy are also advised to support their immune system, as this may help prevent a recurrence during pregnancy.
Rubella
What Is Rubella?
Rubella is a viral infection that is spread through respiratory droplets. People with rubella can be contagious even before the first symptoms appear. Alongside fever, a typical symptom is a rash with red spots. Swollen lymph nodes may also occur.
The characteristic symptoms do not always appear, which means the infection can sometimes go completely unnoticed. Most people either had rubella during childhood or have been vaccinated and are therefore immune.
Rubella During Pregnancy – Can It Be Passed to the Baby?
If a woman develops a rare first-time rubella infection during pregnancy, the virus can be transmitted to the baby. There is also an increased risk of miscarriage or preterm birth. For this reason, one of the first routine antenatal checks includes testing immunity to rubella, for example through a blood test.
Many women are already immune as a result of a previous infection or vaccination. Vaccination is not recommended during pregnancy, as it may be harmful to the unborn baby.
A first-time rubella infection is particularly risky during the early weeks of pregnancy because it can be transmitted to the unborn baby through the placenta. The earlier in pregnancy the baby becomes infected, the greater the risk of miscarriage, preterm birth, or complications. At this stage, organ development is not yet complete, and there is a risk of damage to organs such as the heart, eyes, and ears. After the 11th week of pregnancy, the likelihood of transmission decreases significantly, and after the 20th week, serious effects on the baby are reported only rarely.
However, even if a woman becomes infected during the first weeks of pregnancy, not every rubella infection results in harm to the embryo. Experience has shown that babies can be born completely healthy despite maternal rubella infection. Some women do not notice the infection at all. If rubella infection is identified during the early weeks of pregnancy, more frequent monitoring may be recommended and suitable treatment options can be discussed with a doctor.
Vaginal Thrush
Signs of Vaginal Thrush
Vaginal thrush is a fairly common infection. It is caused by yeast fungi that naturally occur on the skin. The immune system normally keeps them from multiplying excessively. Hormonal changes, such as those that occur during pregnancy, can alter the vaginal environment and allow yeast to grow more easily. Vaginal thrush may cause itching, burning, a whitish, crumbly discharge, inflammation in the intimate area, and pain during sexual intercourse or when passing urine. It can usually be treated quickly and easily, meaning that symptoms often disappear within a short time.
Fungal Infection During Pregnancy – Risk of Infection for the Baby?
During pregnancy, a woman's oestrogen levels are particularly high. These hormonal changes can affect the immune system and alter the vaginal flora. As a result, fungal infections may occur more frequently. However, they usually do not cause severe symptoms and are generally harmless to the unborn baby.
However, vaginal infections are associated with a slightly increased risk of premature labour, miscarriage, and preterm birth.
If the baby becomes infected during birth, it may develop a fungal infection of the mouth and throat (known as oral thrush) or nappy rash. Both conditions can usually be treated successfully.
A fungal infection can be dangerous for premature babies weighing less than 1,500 grams at birth. As their immune systems are not yet fully developed, they have a higher risk of developing Candida sepsis, a serious condition in which yeast fungi can affect multiple organs. This requires immediate treatment in hospital.
Treatment for Vaginal Thrush
When treating vaginal thrush, it is important to discuss with a doctor whether medication is necessary and suitable during pregnancy. Oral antifungal medications are generally not recommended for pregnant women. In many cases, a short course of vaginal pessaries or antifungal creams is sufficient. Women who are prone to fungal infections can take preventive measures. It is advisable to wear breathable cotton underwear and avoid perfumed soaps or creams, which may further irritate the skin.
Streptococci (GBS)
What Are Streptococci?
Streptococci are bacteria that can be spread through droplet transmission or direct contact. There are different types of streptococci, which can cause different illnesses.
In most healthy people, an infection causes no problems. In some cases, however—especially in people with weakened immune systems—certain streptococcal infections can lead to serious health complications and require treatment.
Group B Streptococci (GBS) can be particularly dangerous for newborn babies because they may cause severe infections such as blood poisoning (neonatal sepsis).
Streptococcal Infection During Pregnancy – Risk of Infection for the Baby?
If a pregnant woman has a Group B Streptococcal (GBS) infection in the vagina, the baby can become infected before or during birth.
When transmission occurs during labour, the bacteria are passed to the baby through the amniotic fluid or the birth canal. Premature babies and babies with a low birth weight are most commonly affected. Premature rupture of membranes or maternal fever during labour may further increase the risk.
If the baby becomes infected while still in the womb, symptoms usually appear within the first seven days after birth, often immediately after delivery.
If infection occurs during birth, symptoms may develop somewhat later, during the first weeks of life.
In the most severe cases, the newborn may develop blood poisoning (sepsis), meningitis, or pneumonia.
Fortunately, only a small proportion of babies develop a serious infection.
Treatment for Streptococcal Infection
Group B Streptococci can be detected in pregnant women through a swab of the vagina and/or rectum. Testing is most useful towards the end of pregnancy (between 35 and 37 weeks of gestation) to help prevent transmission during birth.
If an infection is suspected, the test is usually covered by health insurance. Some health insurers also cover the test as part of routine antenatal care even when there are no symptoms. Your doctor or health insurer can provide further information. For self-paying patients, the test typically costs between €20 and €40.
If a Group B Streptococcal infection is detected towards the end of pregnancy, the mother is usually given antibiotics during labour. Treatment earlier in pregnancy is generally not helpful because the bacteria often remain in the body and the baby could still become infected during birth. If the mother is known to carry Group B Streptococci, the baby will be monitored closely after birth. Should the baby develop a fever or other symptoms, the doctor can decide whether antibiotic treatment is necessary.
Toxoplasmosis
Symptoms of Toxoplasmosis
Toxoplasmosis is a disease caused by parasites. Infection usually occurs through contact with cats or by eating raw or undercooked meat. In people with a healthy immune system, infection is almost always harmless and often goes unnoticed. If there are no symptoms or only mild symptoms, treatment is usually not required. When symptoms do occur, they are often similar to those of the flu and may include headaches, sore throat, fever, muscle aches, fatigue, and swollen lymph nodes.
Toxoplasmosis During Pregnancy – Risk of Infection for the Baby?
A first-time toxoplasmosis infection during pregnancy may result in the parasite being passed on to the baby, as the mother's body has not yet produced protective antibodies. In such cases, there is a risk of miscarriage or illness in the baby.
In many cases, illness in the baby is mild. However, some babies may develop symptoms that require treatment. For example, a newborn may develop jaundice or fluid accumulation in the abdomen. In rare cases, more serious complications such as heart failure can occur.
If the mother becomes infected for the first time early in pregnancy, the likelihood of transmission to the unborn baby is lower. As pregnancy progresses, the risk of transmission increases, while the severity of the disease in the baby generally decreases.
Treatment for Toxoplasmosis
Testing for toxoplasmosis is not part of routine antenatal screening. The cost is usually covered by health insurance only if there is a suspected infection. For self-paying patients, a blood test typically costs between €17 and €21. The test can also determine whether the infection is recent or occurred in the past.
If an acute toxoplasmosis infection is diagnosed in the mother, treatment with appropriate medication is usually started. In consultation with a doctor, the pregnancy may be monitored more closely to ensure the baby is developing well. To rule out complications, the doctor may recommend regular ultrasound examinations.
A baby who has already become infected in the womb can be treated with specialised medication after birth.
To help prevent toxoplasmosis during pregnancy, it is recommended to avoid eating raw or undercooked meat, wash raw fruit and vegetables thoroughly, take care when handling cats and cat litter, and wash your hands thoroughly before eating. Good hand hygiene is especially important after gardening or after visiting playgrounds and sandpits.
Chickenpox
What Is Chickenpox?
Chickenpox is the initial infection caused by the varicella-zoster virus. It is highly contagious and typically causes a characteristic rash that appears across the entire body. Fever, headaches, and aching limbs may also occur.
Most people contract chickenpox during childhood and are therefore immune as adults.
Chickenpox During Pregnancy – Risk of Infection for the Baby?
Most women have already had a primary chickenpox infection during childhood and therefore do not need to worry about becoming infected during pregnancy. If immunity is not present, pregnant women are advised to avoid contact with infected individuals whenever possible.
The risk of transmission to the unborn baby usually exists only if the mother develops chickenpox for the first time during pregnancy.
If a woman develops chickenpox for the first time during pregnancy, the baby can become infected while still in the womb. Transmission may also occur during birth through direct contact.
The timing of the first infection is crucial. The most critical periods are the first 24 weeks of pregnancy and the time shortly before or around birth.
If the mother develops chickenpox during the first 24 weeks of pregnancy, the unborn baby may become infected in the womb. In rare cases, this can lead to severe complications, including abnormalities affecting the skin, eyes, and skeleton, or neurological damage.
Chickenpox occurring shortly before or after the baby is born should also be monitored carefully, especially in premature babies. In the most severe cases, the infection can lead to encephalitis (inflammation of the brain) or pneumonia in the newborn, which can be life-threatening. However, the course of the illness is usually mild in otherwise healthy newborns. They may also develop a rash, but treatment is often not necessary, and the infection is simply monitored until it resolves on its own.
Treatment for Chickenpox
A blood test to check immunity to chickenpox is not part of routine antenatal screening. However, some health insurers may cover the cost, for example if there has been a potential exposure to the virus. If you are unsure, it is best to speak with your doctor or health insurer.
If an infection occurs, a doctor can usually recognise chickenpox immediately based on its characteristic rash.
In most cases, chickenpox is treated only with creams or lotions to relieve itching, while the infection is allowed to run its course and resolve on its own.
If treatment is required during pregnancy, antiviral medication or a so-called antiserum may be used. The most appropriate treatment should be discussed with a doctor.
If a chickenpox infection could pose a risk to a baby shortly after birth, the baby will be closely monitored and may also receive antiviral medication.
Cytomegalovirus (CMV)
What Is Cytomegalovirus?
Cytomegalovirus (CMV) is a virus that belongs to the herpes virus family. It can be transmitted through bodily fluids such as saliva, semen, urine, blood, and breast milk. In most cases, CMV infection causes few or no noticeable symptoms. When symptoms do occur, they are often similar to those of a mild flu, such as fatigue, fever, and cough, which is why the infection often goes unrecognised. Like all herpes viruses, CMV remains in the body for life and can reactivate from time to time.
Cytomegalovirus (CMV) During Pregnancy – Risk of Infection and Effects on the Baby
A first CMV infection during pregnancy is rare, but it can pose a risk to the baby. Reinfection is also possible, which means a woman can develop CMV during a second, third, or later pregnancy as well. For this reason, it is particularly important to avoid a first CMV infection during pregnancy whenever possible. If a pregnant woman becomes infected with CMV for the first time, there is a risk that the virus can be transmitted to the baby.
An infection during the first trimester of pregnancy is considered the most concerning for the unborn baby. If transmission occurs at this stage, there is an increased risk of organ damage or developmental problems. Because hearing or vision impairments can sometimes develop later, children with a confirmed CMV infection are usually monitored regularly.
In most cases, however, CMV infection has no lasting effects on the child, and babies are born completely healthy.
Treatment for Cytomegalovirus
CMV can be detected through a blood test. This test is not included in routine antenatal screening and must usually be paid for by pregnant women who have no symptoms. The cost is typically between €17 and €20.
There is no universally established treatment for CMV. For pregnant women, prevention is therefore especially important. Measures such as frequent handwashing are strongly recommended.
Because CMV can also be transmitted through breastfeeding, women with a confirmed CMV infection may choose, as a precaution, to avoid breastfeeding or to boil expressed breast milk before giving it to their baby.
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For many women, some symptoms can initially cause concern about their own health and their baby's wellbeing. With prompt medical care, effective treatment is usually available.
Any Questions or Concerns?
Do you have additional questions about illnesses during pregnancy?
- In our article "Pregnant and Living with a Chronic Condition", you can find tips and guidance on managing chronic illnesses during pregnancy, as well as information about medications during pregnancy.
Have you been diagnosed with a medical condition and are now worried about whether your baby could be affected? Are you facing different tests and examinations?
- find out when you should see a gynaecologist during pregnancy.
Are you not yet sure whether you are pregnant and wondering whether your symptoms could be signs of pregnancy or whether they may be caused by an illness? Read more here: "Am I Pregnant?"
