Hand, foot, and mouth disease (HFMD) is a common viral infection, often associated with young children, but it can cause concern when contracted by an expectant mother. While HFMD is generally mild and self-limiting in adults, its timing during pregnancy determines the need for close monitoring. The illness is typically caused by viruses from the Enterovirus family, most often Coxsackievirus A16 and Enterovirus 71.
Understanding Hand, Foot, and Mouth Disease
HFMD manifests through a characteristic set of symptoms, usually beginning with a fever and a general feeling of being unwell. Within a day or two, painful sores develop inside the mouth, often starting as small red spots that blister and become ulcers. A non-itchy rash of flat or raised red spots may then appear on the palms of the hands and the soles of the feet.
The viruses responsible for HFMD are highly contagious, making exposure common in households with young children. Transmission occurs mainly through contact with respiratory secretions (saliva or nasal mucus) or blister fluid. The fecal-oral route is also a significant mode of spread, especially when changing diapers or if hand hygiene is inadequate. People are most contagious during the first week of the illness, although the virus can remain in the stool for weeks.
Maternal and Fetal Risks by Pregnancy Stage
For most pregnant individuals, contracting HFMD results in a mild illness, often with no symptoms. During the first trimester, a high fever from any infection, including HFMD, carries a theoretical, though rare, risk of miscarriage. However, data does not clearly indicate that HFMD specifically causes adverse pregnancy outcomes, such as congenital disorders.
The risk of the virus crossing the placenta and directly affecting the fetus is considered very small. For infections occurring throughout the second and early third trimesters, the disease is typically mild for the mother and poses little measurable risk to the developing fetus. The primary concern at any stage is supportive care, particularly managing fever and avoiding dehydration.
If symptoms are present, they usually resolve within seven to ten days, and the pregnancy can proceed normally. Medical providers may recommend additional monitoring, such as non-stress tests or ultrasounds, if the pregnant person experiences severe symptoms or if the infection occurs later in pregnancy.
Concerns Regarding Transmission During Delivery
The most significant concern regarding HFMD occurs when the infection is acquired in the final weeks leading up to delivery. In this scenario, there is a small chance of vertical transmission, meaning the virus can be passed from the mother to the newborn. If the newborn becomes infected, they typically develop a mild form of HFMD.
Though uncommon, a perinatally acquired infection can, in rare instances, lead to a more severe, systemic illness in the newborn. This condition may present as a neonatal sepsis-like illness, sometimes involving multiorgan failure, requiring intensive medical care. Because of this risk, a pregnant person diagnosed with HFMD close to their due date will be closely monitored, and pediatric specialists will be alerted. The highest risk of transmission is during the first week of the mother’s illness, so providers may try to avoid delivery during this period.
Prevention and Symptom Management
Expectant mothers, especially those with young children, should focus on meticulous hygiene to minimize the risk of infection.
Prevention Tips
- Frequent and thorough handwashing with soap and water is the most effective preventative measure, particularly after changing diapers and before preparing food.
- Avoid close contact, such as hugging or sharing utensils with individuals known to be sick.
- Disinfect high-touch surfaces and objects, such as toys and doorknobs, to limit the spread of the virus.
If an infection does occur, management is supportive, centering on rest and staying well-hydrated. Acetaminophen can be used to manage fever and pain from mouth sores, but nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided, particularly in the third trimester. Any pregnant person who suspects they have HFMD, especially if they have a high fever or are near their due date, should consult their obstetric provider immediately.