A recent comprehensive study has revealed a concerning link between mpox (formerly monkeypox) infection during pregnancy and a substantially elevated risk of fetal loss. The research indicates that contracting mpox, particularly in the first trimester, can lead to severe adverse outcomes for the developing fetus.

The study, which combined data from multiple cohorts in the Democratic Republic of the Congo, followed pregnant women diagnosed with mpox. Among participants with known pregnancy outcomes, a significant percentage experienced adverse events, with nearly half of all pregnancies resulting in fetal loss. This included spontaneous abortions, missed abortions, and stillbirths. Furthermore, some live births resulted in infants with congenital mpox-like lesions, with a tragic instance of neonatal death shortly after birth.

Researchers noted that adverse outcomes were most frequent when mpox infection occurred during the first trimester of pregnancy, with a staggering 94% of pregnancies experiencing negative consequences. The risk decreased in later trimesters but remained significant. Factors such as high viral load in skin lesions, genital lesions, sexual contact with a symptomatic individual, and HIV infection were also identified as contributing to adverse pregnancy outcomes.

While most adults recover from mpox with mild illness, pregnant individuals are considered a high-risk group due to the immunological and hormonal changes that occur during pregnancy. The virus has been shown to be transmissible from mother to fetus via the placenta, a phenomenon known as vertical transmission. This underscores the critical need for increased vigilance and protective measures for pregnant individuals.

Health authorities emphasize that pregnant, recently pregnant, and breastfeeding individuals should be prioritized for medical treatment if mpox infection is suspected or confirmed. Antiviral treatments, such as tecovirimat, may be considered in consultation with healthcare providers, although data on its impact during pregnancy is still being gathered. Vaccines like JYNNEOS are available for high-risk individuals, but thorough discussion of risks and benefits with a healthcare provider is advised.

The findings highlight an urgent need for greater awareness, improved diagnostic capabilities, and further research to develop comprehensive strategies for preventing and managing mpox in pregnant populations, especially in regions where the virus is endemic.