Rubella poses a risk to pregnancy, including miscarriage and congenital abnormalities. Because of this, a person should get tested for rubella immunity before becoming pregnant.

In the United States, the risk of rubella infection is very low. From 2005 to 2018, only 15 babies had rubella.

Some people, especially those who have not had a vaccination, should get tested for rubella immunity before considering pregnancy.

This article looks at rubella’s effect on pregnancy, rubella immunity testing, vaccination, and more.

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Rubella, also known as German measles, or three-day measles, is a viral infection that causes a distinctive rash. The rash can present as red, purple, or darker spots on a person’s skin.

The rash may feel bumpy or rough. It typically starts on the face and spreads over the body. In babies, the rash is sometimes called blueberry muffin syndrome.

Other symptoms of rubella include:

Rubella is an airborne disease that can transfer from person to person through particles in coughs and sneezes.

However, if a pregnant person contracts rubella, they can also pass it to their fetus.

Rubella that spreads to a fetus can cause congenital abnormalities or miscarriage. The best way to protect against rubella is by getting the measles, mumps, and rubella (MMR) vaccine.

If a person gets rubella while pregnant, it can be dangerous for the developing fetus.

Rubella during pregnancy can lead to potentially severe congenital abnormalities for the developing fetus. It is known as congenital rubella syndrome (CRS) when it affects the fetus. Some of the more common abnormalities include:

Less commonly, a baby may develop:

Severe abnormalities commonly occur when a person contracts rubella during the first trimester. There is no cure for these abnormalities, so getting the MMR vaccination before getting pregnant is important.

Rubella can cause miscarriage or congenital abnormalities, particularly when someone contracts it in the first trimester. The Centers for Disease Control and Prevention (CDC) states that rubella is no longer present in the U.S. as of 2004.

However, the CDC also says that rubella can still occur in the U.S. when unvaccinated people come into contact with people who have the virus.

This typically happens after people have traveled to countries that have not yet eliminated the virus. This includes some countries in Africa, the Middle East, and South and Southeast Asia.

A serology test identifies whether someone has antibodies to fight against a specific infection or disease. When testing for rubella, a healthcare professional uses an IgG test.

An IgG test is a useful way to identify whether someone planning to become pregnant has antibodies to protect them and their baby against rubella. If the IgG test is positive, the person will not require a vaccine.

However, people planning pregnancy who have a negative IgG test should have a vaccination to prevent them from contracting the virus during pregnancy.

When to get tested

Anyone planning a pregnancy should have an IgG serology test to determine whether they are immune to rubella.

An IgG test involves a healthcare professional taking a blood sample and sending it to a lab for testing. A person should receive their results within a few weeks.

The test may take place in a clinic or another healthcare setting.

The test results determine whether a person has specific antibodies in their blood to protect them against rubella.

What does a positive rubella IgG test mean?

A positive IgG test means the person is immune to rubella. This could be because they have had rubella or an MMR vaccine and still have antibodies that can fight against the disease.

A person with a positive IgG test will not require the MMR vaccine.

What does a negative rubella IgG test mean?

If a person has a negative rubella IgG test, they are not immune to rubella and could contract the disease.

If a person has a negative IgG test and plans to become pregnant, they will need to have the MMR vaccine before they become pregnant.

The CDC recommends that people who are planning to become pregnant speak with a doctor about testing and vaccination beforehand.

However, a person should avoid conceiving for at least 4 weeks after having the MMR vaccine. This is because the rubella vaccination contains live rubella antibodies that could endanger the fetus.

A person who is already pregnant should not get the MMR vaccine. If a person contracts rubella or has exposure to it while pregnant, they should contact a doctor immediately.

People who are pregnant and have not had the vaccination should wait until after giving birth to receive the MMR vaccine.

Most children living in the U.S. receive the MMR vaccination as part of their vaccination schedule.

Children get 2 doses of MMR vaccination. Doctors administer them as follows:

  • first dose at 12–15 months
  • second dose at 4–6 years of age or as early as 28 days after the first dose

This section answers some frequently asked questions about rubella immunity testing and pregnancy.

Can I get a rubella vaccine while pregnant?

The CDC does not recommend a person get the MMR vaccine while pregnant. Instead, a person or couple considering pregnancy should get the vaccination before trying to conceive.

Most people living in the U.S. would have received the vaccine as a child. If not, a person will likely want to get it before conceiving.

Once vaccinated, they should wait at least 4 weeks before trying to conceive because the vaccination contains live antibodies that could endanger the fetus.

Is it safe to get a rubella vaccine while breastfeeding?

A person can have the MMR vaccination while breastfeeding or chestfeeding. It will not pass to the fetus and will prevent rubella.

Does rubella affect fertility?

It is not likely that rubella will cause fertility issues.

However, a person should wait 4 weeks before attempting to get pregnant if they receive the MMR vaccination.

This is because the live rubella antibodies in the vaccine could endanger the fetus.

Most people living in the U.S. will not come in contact with rubella unless traveling to other countries where rubella is still present.

However, an unvaccinated person considering pregnancy should consider getting the MMR vaccine.

Doctors and other healthcare professionals also recommend that people who are pregnant or considering becoming pregnant should get tested for immunity to rubella.

Having immunity to rubella due to having had the condition or the MMR vaccine can help protect a person from contracting the infection. It will also prevent potential complications during pregnancy, such as miscarriage or congenital abnormalities.