This sheet is about having rubella in pregnancy or while breastfeeding. This information is based on published research. It should not take the place of medical care and advice from your healthcare providers.
What is rubella?
Rubella is a viral infection. Rubella has sometimes been called “German measles” or the “three-day measles”, but it is not caused by the same virus that causes measles.
What are the symptoms of rubella?
Not everyone will develop symptoms if they have rubella. Among people who do develop symptoms, they usually show up around 14 days (2 weeks) to 21 days (3 weeks) after exposure.
Rubella can cause low-grade fever, sore throat, red and irritated eyes, swollen and tender lymph nodes, and a rash that starts on the face. The rash might spread to the rest of the body. In addition, women with rubella can develop joint pain (often in knees, wrists, and fingers). Joint pain is rare in children or men with rubella. Men might have pain and swelling in the testicles.
How do you get rubella?
Rubella is contagious (can spread from person to person). When people who have rubella cough, sneeze, or talk, droplets containing the virus are spread through the air. You can catch rubella by being close to someone who is infected. People who have previously had rubella are unlikely to become reinfected if they are exposed again.
People with rubella can spread rubella to others from about 7 days (1 week) before the rash appears to 14 days (2 weeks) after the rash appears. Some people who get rubella have no symptoms but can still spread the virus to others.
A pregnant woman can pass rubella to her fetus. This infection can cause congenital rubella infection.
How can I lower my chances of getting rubella?
The best way to protect yourself against rubella is to get the measles, mumps, and rubella (MMR) vaccine. MotherToBaby has a sheet on the measles, mumps, and rubella (MMR) vaccine here: https://mothertobaby.org/fact-sheets/measles-rubella-and-rubella-mmr-vaccine/. Since live vaccines like MMR are not usually given during pregnancy, it is important to make sure you are up to date with the MMR vaccination before getting pregnant or after delivery.
Other ways to reduce your chances of getting rubella are to
- Avoid close contact with people who have rubella or are sick with a rash and fever.
- Avoid crowded areas if a rubella outbreak is taking place near you.
- Wash your hands often with soap and water.
- Encourage other people living in the home to stay up to date on the MMR vaccine.
I have rubella. Can it make it harder for me to get pregnant?
It is not known if having rubella can make it harder to get pregnant.
Does having rubella increase the chance of miscarriage?
This has not been well-studied. Miscarriage is common and can occur in any pregnancy for many different reasons. Human case reports have suggested that infection with rubella during pregnancy might increase the chance of miscarriage.
Does having rubella during pregnancy increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like rubella, might increase the chance of birth defects in a pregnancy.
If a woman gets rubella, the virus can pass to the fetus. This infection can cause congenital rubella infection. Some fetuses who become infected can develop birth defects or other conditions, including hearing loss. The birth defects noted to happen with congenital rubella infection have been called congenital rubella syndrome (CRS). CRS is more likely to happen if infection occurs in the first 16 weeks of pregnancy.
Babies with CRS can have hearing loss, heart defects, and cataracts (cloudy films that form over the lens of the eyes that can affect vision). Some common facial features have also been reported, including a triangular-shaped face, prominent nose, and hair whorl at the forehead hairline.
Not all babies with CRS will have all these symptoms. A fetus is more likely to be affected by CRS if the rubella infection happened during the first trimester of pregnancy. However, rubella infection at any time in pregnancy carries a chance of the fetus developing congenital rubella infection.
Does having rubella increase the chance of other pregnancy related problems?
Congenital rubella infection can increase the chance of preterm delivery (birth before week 37) or stillbirth (fetal death after 20 weeks). Congenital rubella infection can also cause growth issues for the fetus and low birth weight.
Does having rubella in pregnancy affect future behavior or learning for the child?
Congenital rubella infection can increase the chance of developmental delay and/or learning difficulties in some children.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used to screen for some birth defects, like heart defects; and can be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any other prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.
How can I reduce my chances of getting rubella?
The best way to protect yourself against rubella is to get the measles, mumps, and rubella (MMR) vaccine. MotherToBaby has a sheet on the measles, mumps, and rubella (MMR) vaccine here: https://mothertobaby.org/fact-sheets/measles-rubella-and-rubella-mmr-vaccine/. Since live vaccines like MMR are not usually given during pregnancy, it is important to make sure you are up to date with the MMR vaccination before getting pregnant or after delivery.
Other ways to reduce your chances of getting rubella are to
- Avoid others who are sick with the illness
- Avoid crowded areas if a rubella outbreak is taking place near you
- Wash your hands well with soap and water
- Encourage other people living in the home to be vaccinated
Breastfeeding while I have rubella:
The rubella virus and maternal antibodies (what the body makes to fight infections) to rubella have been found in breastmilk. There is at least 1 reported case of a woman who developed rubella after delivery. Her breastfed infant tested positive for the virus but did not develop any symptoms.
If you have rubella, talk to your healthcare provider about the best ways to prevent the spread of illness to your baby. If you suspect that your baby has any symptoms of rubella, contact the child’s healthcare provider right away. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man has rubella, can it affect fertility or increase the chance of birth defects?
A man with rubella can spread the virus to a pregnant woman through close contact. Some men with rubella develop inflammation of the testicles (orchitis), which can temporarily lower fertility (ability to make healthy sperm). In most cases, fertility returns to what it was previously. One study did not find an increased chance for birth defects in the offspring of men who had rubella infection of the testis. For more general information, please see the MotherToBaby sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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