Why Measles Poses Added Risks During Pregnancy

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Monitoring and preventing measles infections among women who are pregnant is a growing concern for obstetricians and infectious disease clinicians. The issue was highlighted at IDWeek 2026, held October 21-24 in Washington, DC. Leaders in gynecology, obstetrics, and infectious disease discussed ways to prepare women before conception, emphasizing the importance of the measles, mumps, and rubella (MMR) vaccine at a time when vaccine hesitancy is growing and infection rates are increasing.¹ Obstetricians and infectious disease specialists still face numerous challenges when managing pregnant patients infected with measles, especially given the current outbreak, in which more unvaccinated patients of reproductive age are contracting measles and are at risk for hospitalization.

Pregnancy confers an elevated risk to both mother and child, Naima T. Joseph, MD, MPH, assistant professor of obstetrics and gynecology and medical director of equity and pregnancy at Boston Medical Center, said in an interview with The American Journal of Managed Care^®.

“In terms of the mom, higher risk of hospitalization, higher risk of complications from respiratory illness,” she explained. “And then there’s always the risk of congenital measles or perinatal transplacental exposure.”

The presentation of measles does not appear to differ in pregnancy, she said. Pregnant patients still present with the same symptoms, such as prodrome, a characteristic rash, Koplik spots, cough, and coryza. However, clinicians also are seeing more atypical presentations among patients who are immunocompromised or of different ethnicities, especially because many clinicians have never seen measles before, Joseph explained.

Recognizing symptoms and effectively isolating and quarantining infected patients poses a significant challenge to containing the spread of infection, she said. Pregnancy adds another consideration.

“For pregnant patients who have been exposed and may not recognize it, there is a very small time window where we want to give them prophylaxis so that we can reduce the risk of transplacental and perinatal transmission to their infant,” Joseph added.

To improve vaccine uptake, Joseph pointed to lessons learned from COVID-19, such as identifying trusted messengers and working within community anchors like churches and barbershops to address concerns and dispel myths about vaccine safety.

“We know that 2 doses are 97% effective against measles,” she said.

Reference

1. McCrear S. FAQ: what the measles outbreak means for payers and health systems. AJMC^®. September 25, 2026. Accessed October 22, 2026. https://www.ajmc.com/view/faq-what-the-measles-outbreak-means-for-payers-and-health-systems