What Happens to Your Baby If You Get Rubella During Pregnancy? Understanding Congenital Rubella Syndrome

Expecting a baby is an exciting time in your life. Even a mild cold or sniffle can sometimes make you feel worried and anxious. That is completely normal. After all, you care so much about your growing little one resting safely inside your womb.

Today, we will talk about what happens if you catch rubella during pregnancy and how it can affect your baby. Doctors call this medical condition Congenital Rubella Syndrome, or CRS for short. Let us break down everything you need to know in simple, clear terms.

What Is Congenital Rubella Syndrome?

Simply put, Congenital Rubella Syndrome (CRS) is a group of health problems that happens when an expecting mother catches rubella, also known as German measles. The virus travels from the mother to the baby. The word congenital simply means present from birth.

When the rubella virus enters your baby's body, it can interfere with normal growth and development. These effects can cause long-term health issues after birth. Examples include cloudy lenses in the eyes, known as cataracts, or heart defects present from birth. The severity of CRS varies from one child to another. Women who catch rubella during the early stages of pregnancy, especially before 13 weeks, face the highest risk of severe effects.

How Common Is This Condition?

In countries like the US and UK, widespread use of the rubella vaccine makes Congenital Rubella Syndrome very rare today. However, globally, about 100,000 cases of CRS still occur every year in developing regions. National immunization programs help control the spread in many countries, but awareness remains critically important for every family.

What Are the Symptoms of Congenital Rubella Syndrome?

The signs and symptoms of CRS vary greatly depending on each unique case. As mentioned earlier, the earlier in pregnancy you catch rubella, the more severe the baby's symptoms tend to be. Sometimes, if the case is mild, your baby might not show any obvious signs right away at birth.

Here are some early signs visible right after your baby is born:

• Low birth weight.
• Small purplish or reddish skin spots that resemble a blueberry muffin appearance.
• Purpura, which refers to purple, red, or brown skin spots and patches.
• Microcephaly, meaning the baby's head is smaller than normal.

Here are other signs that may show up as your baby grows a bit older:

• Congenital cataracts, which cause cloudy lenses in the eyes, and glaucoma, which raises eye pressure.
• Congenital heart disease, including holes between heart chambers like ventricular and atrial septal defects.
• Blood vessel issues in the heart, such as patent ductus arteriosus and peripheral pulmonary artery stenosis.
• Developmental delays, meaning your baby takes longer to roll over, sit, walk, or speak.
• Hepatosplenomegaly, which is an enlargement of the liver or spleen.
• Hearing loss, which can sometimes range from mild to complete deafness.
• Hemolytic anemia, caused by the breakdown of red blood cells.
• Intellectual disability.
• Pneumonia.
• Meningoencephalitis, an inflammation of the brain and its protective coverings.
• Pigmentary retinopathy, an eye disease affecting the retina.
• Bone disease.
• Swollen lymph nodes.

Important Note: Babies born with Congenital Rubella Syndrome have a higher risk of developing insulin-dependent diabetes and thyroid disease later in life.

What Causes This Condition?

The primary cause of Congenital Rubella Syndrome is catching the rubella infection while you are pregnant. The virus crosses the placenta, which is the organ that nourishes your baby, and infects the fetus. The virus damages growing cells and disrupts normal organ development, leading to birth defects.

Consider how the risk changes across pregnancy:

• If you catch rubella during the first 12 weeks of pregnancy, up to 85 percent of newborns can develop CRS.
• If the infection happens between weeks 13 and 16, about 50 percent of newborns are affected.
• If infection occurs during the second half of the second trimester, roughly 25 percent of newborns experience effects.

Rubella is caused by the rubella virus. The classic sign is a red rash starting on the face and spreading across the body. Vaccination has made it rare in many places, but it still exists in various parts of the world.

Can Babies with CRS Spread the Virus?

Yes, this is an important fact to keep in mind. Doctors consider a baby born with Congenital Rubella Syndrome capable of spreading the virus for at least one year. However, if your baby passes two separate rubella tests spaced one month apart after turning three months old and both results are negative, they are no longer contagious. Take extra precautions during this period to protect vulnerable people around you.

How Is CRS Diagnosed?

Doctors use several methods to diagnose Congenital Rubella Syndrome:

• Pregnancy Screening: Routine blood tests early in pregnancy check for rubella immunity and other infections. If you show symptoms, your doctor will order diagnostic tests to confirm and discuss potential risks.
• Prenatal Testing: If you contract rubella while pregnant, specialized tests can check if the virus reached your baby. Examples include amniocentesis, chorionic villus sampling, and fetal blood sampling. Doctors recommend these complex procedures only when necessary.
• Postnatal Testing: After birth, doctors can run blood tests to look for antibodies fighting the rubella virus. Urine, saliva, or nasal swab samples also help detect the virus. Doctors order these tests if rubella exposure occurred during pregnancy or if the baby shows signs of CRS.

If tests confirm your baby has rubella, your medical team will recommend additional evaluations to check their overall health and manage any arising issues.

What Are the Treatments Available?

Unfortunately, no direct cure or specific treatment exists for Congenital Rubella Syndrome. also, some impacts, such as hearing loss and intellectual disabilities, are permanent. However, doctors can manage certain symptoms like hemolytic anemia or pneumonia. Surgery can also successfully repair specific heart defects.

Your baby's medical team will create a specialized care plan tailored to your child's specific needs and symptoms, often involving multiple pediatric specialists.

What Should I Expect If My Baby Has CRS?

Congenital Rubella Syndrome affects every child differently, and severity varies widely. Fully understanding how CRS impacts your child requires a series of thorough evaluations and tests. This process takes time, but please remember you are never alone. Your doctor and care team will support you, explain what CRS means, and guide you on what to expect for your child and family's future.

Can I Prevent This Condition?

Yes! This is the most important message: Congenital Rubella Syndrome is largely preventable!

The best way to protect your baby is to ensure you are immune to the rubella virus before you get pregnant by receiving the rubella vaccine.

In many countries, children receive the MMR vaccine, which covers measles, mumps, and rubella. The first dose is typically given between 9 and 12 months, and the second dose around age 3. Check with your local health clinic for your national schedule.

If you did not receive this vaccine in childhood or feel unsure, talk to your doctor right away to get vaccinated. If you receive the vaccine as an adult, remember that you must wait 28 days, roughly one month, before attempting to get pregnant. This guidance is extremely important.

How to Care for a Baby with CRS?

Depending on your baby's specific health needs, ongoing medical care and therapies may be necessary as they grow. Advocating for your baby and ensuring they receive the best medical support and facilities is vital. This active involvement gives your child the best possible quality of life.

Congenital Rubella Syndrome presents serious challenges to infant health. Fortunately, the MMR vaccine makes prevention possible. Whenever possible, consult your doctor before getting pregnant to confirm immunity against rubella and other infections. This step protects both you and your baby.

CRS vs. Normal Infant Health Comparison.