Symptoms of rubella during pregnancy include a fever, a rash, and a sore throat. However, many people with rubella do not display symptoms and may not know they have the infection.

Since the rubella vaccination protects a person for life, the infection is rare in countries such as the United States that include the rubella vaccine in routine childhood vaccinations.

However, people who have not received the vaccination can contract rubella, often through travel to countries where the infection is common.

While rubella usually does not cause serious problems for adults, the infection can be dangerous for a fetus. If a person contracts rubella while pregnant, it can cause severe congenital disorders.

This article will examine rubella and pregnancy, including symptoms, impact, treatment, testing, and vaccination.

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This feature mentions pregnancy loss, stillbirth, or both. Please read at your own discretion.

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Up to 50% of people who contract rubella do not develop symptoms. They may not be aware they have an infection.

When symptoms do develop, they are usually mild.

Flu-like symptoms appear first, followed by a rash. This rash may appear light pink or red on white skin. It may be difficult to see on brown skin but might feel rough or bumpy.

The rash lasts about 3 days and often starts on the face before spreading to the rest of the body.

Other symptoms include:


The rubella virus is highly contagious. It is airborne and can spread via:

  • coughing
  • sneezing
  • sharing food or drink

Rubella can also pass from a pregnant person to a fetus during pregnancy.

Part of what makes rubella so contagious is that it is transmissible while a person is asymptomatic. This means people can spread rubella even if they do not develop symptoms.

People with symptomatic rubella can spread the virus up to a week before the appearance of a rash.

If a pregnant person acquires rubella, the infection can cause congenital rubella syndrome (CRS) in the fetus.

CRS can cause congenital disorders, many of which are serious.

These include:

Some CRS-related anomalies are less common, such as:

Rubella in pregnancy can also cause miscarriage.

Rubella treatment usually involves symptom management using nonsteroidal anti-inflammatory drugs (NSAIDs). Bed rest and an increased fluid intake may also help.

When a pregnant person contracts rubella, the gestation age of the fetus may affect treatment decisions.

If they contract the infection before 18 weeks of gestation, some clinicians may suggest pregnancy termination as an option because of the likelihood of severe congenital disorders.

If they contract the infection after 18 weeks of gestation, the fetus may experience effects that are less severe.

After birth, CRS treatment addresses organ-specific symptoms in the infant. Children with CRS often have multidisciplinary care teams to address the issues they may experience.

Rubella immunoglobulin G (IgG) testing is a type of serology testing to assess a person’s immunity to rubella.

The Centers for Disease Control and Prevention (CDC) recommends the use of this test before, during, and after pregnancy.

Serology is the process of examining blood serum and secretions such as saliva, usually to assess an immune system response. Serum is the watery part of the blood that does not clot and contains disease-fighting antibodies.

Rubella IgG testing while pregnant

IgG is the most abundant immune system protein and the only immunoglobulin capable of crossing the placenta.

IgG testing involves measuring the avidity of IgG. Avidity is the binding strength between antibodies and an antigen.

With most viruses, avidity increases over time. This means that IgG testing can help identify whether immunity is from a new or previous infection.

If a person tests positive for rubella IgG, the likelihood of acquiring a rubella infection is low.

Immunoglobulin M testing

While IgG testing assesses immunity, immunoglobulin M (IgM) testing identifies active infection.

Serology testing for rubella IgM can confirm suspected cases of rubella. It can also identify CRS in newborns and infants.

The CDC advises against routine IgM screening in asymptomatic people because of the chance of false positive test results.

The rubella vaccine is a live virus vaccine and healthcare professionals should not administer it during pregnancy.

The CDC recommends that those who wish to become pregnant get the rubella vaccine at least 4 weeks before conception.

It also states that people should take steps to avoid becoming pregnant for at least 4 weeks after receiving the rubella vaccine, and pregnant people who have not received a vaccination should wait until after they have given birth to do so.

Rubella is a contagious viral illness that is dangerous to fetuses. A rubella infection in a pregnant person can cause severe congenital disorders and pregnancy loss.

The rubella vaccine is a weakened but live version of the virus. According to the CDC, people should not receive it during pregnancy or within the 4 weeks before conception.

Serology testing can reveal whether a person has immunity to rubella. Testing may also detect the presence of an active infection.

Rubella treatment aims to reduce the impact of symptoms, usually with the use of NSAIDs.