Measles in pregnancy: a descriptive study of 58 cases

OBJECTIVE: To describe the effects of measles in pregnancy using a large case series. METHODS: Pregnant women with measles were identified by county health department records, and their hospital and clinic records were reviewed. When available, records for the infants of case patients were also reviewed. RESULTS: Fifty-eight pregnant women with measles were identified. Thirty-five (60%) were hospitalized for measles, 15 (26%) were diagnosed with pneumonia, and two (3%) died of measles complications. Excluding three induced abortions, 18 pregnancies (31%) ended prematurely; five were spontaneous abortions and 13 were preterm deliveries. All but two of the 18 pregnancies that terminated early did so within 14 days of rash onset. Two term infants were born with minor congenital anomalies, but their mothers had measles late in the third trimester. No newborns were diagnosed with congenital measles. CONCLUSIONS: The incidence of death and other complications from measles during pregnancy may be higher than expected for age-comparable, nonpregnant women. Measles in pregnancy may lead to high rates of fetal loss and prematurity, especially in the first 2 weeks after the onset of rash.