Rubella is a typically mild childhood viral infection that may, however, have devastating consequences for infants infected before birth.
Rubella is caused by a virus.
The fetus or newborn may have symptoms depending on when during the pregnancy infection occurred.
Blood tests and tests of other samples can be done to detect the virus in the fetus, newborn, or mother.
Vaccination of the mother before becoming pregnant can prevent the infection in the fetus.
There is no specific treatment for the infection.
(See also Overview of Infections in Newborns and Rubella in older children and adults.)
When a baby is born with rubella, the infection is called congenital rubella. In congenital rubella, a woman infected during the first 16 weeks (particularly the first 8 to 10 weeks) of pregnancy passes the virus to the fetus through the placenta (the organ that provides nourishment to the fetus). This infection in the fetus causes miscarriage, stillbirth, or multiple, severe birth defects. The earlier in pregnancy the infection occurs, the greater the risk of severe abnormalities.
Congenital rubella is rare in the United States because rubella vaccination of girls and young women has become routine.
Symptoms of Rubella in Newborns
Depending on when during the pregnancy the fetus is infected, it may have no symptoms or may be stillborn. Infants who survive may have multiple birth defects. These birth defects are referred to as congenital rubella syndrome (CRS).
The most common symptoms of congenital rubella syndrome in newborns include
Low birth weight
Brain inflammation
Damage to the retina (the transparent, light-sensitive structure at the back of the eye)
Enlarged liver and spleen
Bruises or other skin spots
Enlarged lymph nodes
Diagnosis of Rubella in Newborns
Tests to measure antibody levels in the mother's blood
Tests of the amniotic fluid or blood in the fetus
Tests to measure antibody levels and to look for the virus in the newborn
Pregnant women are routinely screened with a blood test early in pregnancy to confirm they are immune to rubella. The test is repeated in women who do not have antibodies to rubella virus and who develop symptoms of rubella.
Fetuses can be diagnosed before birth by testing the amniotic fluid or blood.
Newborns suspected of having congenital rubella syndrome should have blood tests to measure antibody levels, and specimens may be taken and tested to look for the virus.
Other tests in the newborn may include a spinal tap and x-rays of the bones to look for abnormalities caused by congenital rubella syndrome. Newborns should also be given thorough eye and heart examinations.
Prevention of Rubella in Newborns
Rubella vaccination of all girls and women of childbearing age before pregnancy can prevent the infection.
Pregnant women who are not immune to rubella should avoid anyone who has rubella and then be given the vaccine immediately after giving birth so that they will be immune during any future pregnancies. Women cannot be vaccinated during pregnancy because the vaccine contains living virus that might infect the fetus. Because of this risk, all women who receive the rubella vaccine should make sure they do not become pregnant for at least 28 days after vaccination.
If an expectant mother who has not been immunized comes into close contact with an infected person early in pregnancy, she may be given an injection of immune globulin to try to help prevent infection.
Treatment of Rubella in Newborns
Support for affected children
No specific treatment is available.
Support and care for a newborn who has congenital rubella syndrome vary depending on the extent of the newborn's problems. Children who have multiple complications require early treatment from a team of specialists.
