The Risks of Rubella in Pregnancy

German Measles in Pregnancy

Couple discusses prenatal testing with doctor
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Rubella, also known as the German Measles, is typically a childhood disease that is mild. However, in pregnancy, when the mother has rubella, there are a number of problems that may occur.

If you have rubella in the first trimester, you have about a 25% risk of having a birth defect, known as congenital rubella syndrome (CRS). These defects can include:

  • heart deformities
  • hearing loss
  • developmental delays
  • eye deformities
  • others

There is also an increased risk of miscarriage and stillbirth following a rubella infection in the mother, with the first trimester being the highest risk timeframe.

If you get rubella in the first trimester, there is an 85% chance your baby will be infected. That drops to only 50% in the second trimester, and 25% chance in the third trimester. There were fewer than ten cases of rubella a year in the United States, but some people are exposed while traveling.

Rubella Vaccines

The good news is that many women today have already been vaccinated against rubella. At your first prenatal appointment, most practitioners will check your rubella status with blood work known as a rubella titer. This will let you know if you are immune from rubella. If you are not immune, you will be offered a rubella vaccination during the immediate postpartum period via the MMR vaccine (Measles, Mumps, Rubella).

You should not get vaccinated during pregnancy.

While most women are rubella immune, about 20 of childbearing aged women are at risk for contracting rubella. In your preconception planning, you can also screen for the rubella antibodies and become immunized if you are not immune. It is recommended that you wait at least a month from being vaccinated before becoming pregnant.


It is also possible to be immune and lose that immunity over time. This is true if you have a larger number of pregnancies, or have a great distance in time between pregnancies. So having your practitioner screen for rubella antibodies before you get pregnant is always a good idea, even if you were previously immune.

Cases of rubella are down 95% since 2000 according to the World Health Organization (WHO). This is large part to the increased use of the rubella controlling vaccine around the world. It is now in 72% of the countries monitored by the WHO.

Symptoms of Rubella in Pregnancy

Rubella most commonly presents as a rash. It may also have flu like symptoms or no symptoms. Your best protection is to avoid infection. Good handwashing technique is a must. If you work with children or have older children and they contract rubella, you are at greater risk of contracting rubella. The most dangerous time to contract rubella is during the first trimester when the risk of miscarriage is much higher.

If you think that you have rubella, you should contact your practitioner for more advice.


Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, Vauloup-Fellous C. Rubella and pregnancy: diagnosis, management and outcomes. Prenat Diagn. 2014 Dec;34(13):1246-53. doi: 10.1002/pd.4467. Epub 2014 Sep 16. Review.

Grant GB, Reef SE, Dabbagh A, Gacic-Dobo M, Strebel PM. MMWR Morb Mortal Wkly Rep. 2015 Sep 25;64(37):1052-5. doi: 10.15585/mmwr.mm6437a5. Global Progress Toward Rubella and Congenital Rubella Syndrome Control and Elimination - 2000-2014.

Rubella and Pregnancy. March of Dimes. March 2012. Last Accessed February 24, 2016.

Schwartzenburg CJ, Gilmandyar D, Thornburg LL, Hackney DN. Pregnancy outcomes of women with failure to retain rubella immunity. J Matern Fetal Neonatal Med. 2014 Dec;27(18):1845-8. doi: 10.3109/14767058.2014.905768. Epub 2014 Apr 9.

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