Maternal Health

Parvovirus B19 (Fifth Disease) in Pregnancy

Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN

Content reviewed against published ACOG, CDC, NIH guidelines

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Your health matters just as much as your baby's. If you are dealing with parvovirus b19 (fifth disease) in pregnancy, here is what you need to know.

The short answer

Fifth disease (caused by Parvovirus B19) is usually mild in adults but can pose risks during pregnancy, including fetal anemia and hydrops fetalis in rare cases. About 50-60% of adults are already immune from childhood exposure. If you are exposed during pregnancy, blood testing can determine your immunity status and guide monitoring.

Key takeaways

  • Fifth disease (caused by Parvovirus B19) is usually mild in adults but can pose risks during pregnancy, including fetal anemia and hydrops fetalis in rare cases. About 50-60% of adults are already immune from childhood exposure. If you are exposed during pregnancy, blood testing can determine your immunity status and guide monitoring.
  • Usually normal when: Being immune to parvovirus from previous exposure (positive IgG antibodies)
  • Call your doctor if: Confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring
  • Varies by age — see the age-by-age breakdown below
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What Parents Should Know

According to ACOG, CDC, NIH guidelines, fifth disease (caused by Parvovirus B19) is usually mild in adults but can pose risks during pregnancy, including fetal anemia and hydrops fetalis in rare cases. About 50-60% of adults are already immune from childhood exposure. If you are exposed during pregnancy, blood testing can determine your immunity status and guide monitoring. At First trimester, parvovirus B19 infection in the first trimester carries a slightly higher risk of miscarriage. If you are exposed (often through school-age children), your provider can test for immunity. If you are already immune (positive IgG, negative IgM), there is no risk. If you are susceptible and infected, the overall risk of serious fetal complications is about 5-10%. It is generally considered normal when being immune to parvovirus from previous exposure (positive IgG antibodies). However, you should contact your pediatrician promptly if confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Being immune to parvovirus from previous exposure (positive IgG antibodies)
Confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring
Having been exposed but testing showing immunity
Ultrasound showing signs of fetal hydrops or anemia

By Age

What to expect by age

First trimester

Parvovirus B19 infection in the first trimester carries a slightly higher risk of miscarriage. If you are exposed (often through school-age children), your provider can test for immunity. If you are already immune (positive IgG, negative IgM), there is no risk. If you are susceptible and infected, the overall risk of serious fetal complications is about 5-10%.

Second trimester

The second trimester (13-20 weeks) is the period when the fetus is most vulnerable to parvovirus-induced anemia. If infection is confirmed, serial ultrasounds (weekly or every 1-2 weeks) are recommended to monitor for signs of fetal anemia. The peak risk for fetal complications is 4-6 weeks after maternal infection.

Third trimester

Fetal risk decreases in the third trimester. If infection occurs, monitoring with ultrasound is still recommended. Most infected pregnancies result in healthy babies, even without treatment. In severe cases of fetal anemia, intrauterine blood transfusion can be life-saving.

What to Tell Your Pediatrician

  • Describe when you first noticed parvovirus b19 (fifth disease) in pregnancy and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you have been exposed to someone with fifth disease (rash illness in a child).
  • Mention if you work with young children and there is an outbreak.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Being immune to parvovirus from previous exposure (positive IgG antibodies)
  • Having been exposed but testing showing immunity
Mention at your next visit when...
  • You have been exposed to someone with fifth disease (rash illness in a child)
  • You work with young children and there is an outbreak
  • You develop a rash, joint pain, or flu-like symptoms after exposure
Act now when...
  • Confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring
  • Ultrasound showing signs of fetal hydrops or anemia

What You Can Do at Home

  • Keep track of when you notice parvovirus b19 (fifth disease) in pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that being immune to parvovirus from previous exposure (positive IgG antibodies) — this is generally within the range of normal.
  • At First trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
  • While monitoring at home, seek immediate care if confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring.

Frequently asked questions

Is parvovirus b19 (fifth disease) in pregnancy normal?
Fifth disease (caused by Parvovirus B19) is usually mild in adults but can pose risks during pregnancy, including fetal anemia and hydrops fetalis in rare cases. About 50-60% of adults are already immune from childhood exposure. If you are exposed during pregnancy, blood testing can determine your immunity status and guide monitoring.
When should I call the doctor about parvovirus b19 (fifth disease) in pregnancy?
Confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring Ultrasound showing signs of fetal hydrops or anemia
When is parvovirus b19 (fifth disease) in pregnancy normal?
Being immune to parvovirus from previous exposure (positive IgG antibodies) Having been exposed but testing showing immunity
What causes parvovirus b19 (fifth disease) in pregnancy?
Fifth disease (caused by Parvovirus B19) is usually mild in adults but can pose risks during pregnancy, including fetal anemia and hydrops fetalis in rare cases. About 50-60% of adults are already immune from childhood exposure. If you are exposed during pregnancy, blood testing can determine your immunity status and guide monitoring. Common explanations include: Being immune to parvovirus from previous exposure (positive IgG antibodies). Having been exposed but testing showing immunity.
What should I mention to my pediatrician about parvovirus b19 (fifth disease) in pregnancy?
You should mention parvovirus b19 (fifth disease) in pregnancy at your next visit if: You have been exposed to someone with fifth disease (rash illness in a child). You work with young children and there is an outbreak. You develop a rash, joint pain, or flu-like symptoms after exposure.
Is parvovirus b19 (fifth disease) in pregnancy normal at First trimester?
Parvovirus B19 infection in the first trimester carries a slightly higher risk of miscarriage. If you are exposed (often through school-age children), your provider can test for immunity. If you are already immune (positive IgG, negative IgM), there is no risk. If you are susceptible and infected, the overall risk of serious fetal complications is about 5-10%.
Is parvovirus b19 (fifth disease) in pregnancy normal at Second trimester?
The second trimester (13-20 weeks) is the period when the fetus is most vulnerable to parvovirus-induced anemia. If infection is confirmed, serial ultrasounds (weekly or every 1-2 weeks) are recommended to monitor for signs of fetal anemia. The peak risk for fetal complications is 4-6 weeks after maternal infection.
Should I go to the ER for parvovirus b19 (fifth disease) in pregnancy?
Seek emergency care if confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring, or if ultrasound showing signs of fetal hydrops or anemia. When in doubt, call your pediatrician's after-hours line for guidance.
Does parvovirus b19 (fifth disease) in pregnancy go away on its own?
In many cases, parvovirus b19 (fifth disease) in pregnancy resolves on its own, especially when being immune to parvovirus from previous exposure (positive IgG antibodies). By Third trimester, fetal risk decreases in the third trimester. If infection occurs, monitoring with ultrasound is still recommended. Most infected pregnancies result in healthy babies, even without treatment. In severe cases of fetal anemia, intrauterine blood transfusion can be life-saving.

References

  1. [1]American College of Obstetricians and Gynecologists. Cytomegalovirus, Parvovirus B19, Varicella Zoster, and Toxoplasmosis in Pregnancy. ACOG Practice Bulletin No. 151, 2015. ACOG
  2. [2]Centers for Disease Control and Prevention. Parvovirus B19 and Pregnancy. CDC, 2023. CDC
  3. [3]National Library of Medicine. Parvovirus B19 in Pregnancy. StatPearls, 2023. NIH

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Parvovirus B19 (Fifth Disease) in Pregnancy.

Things to mention

  • Describe when you first noticed parvovirus b19 (fifth disease) in pregnancy and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you have been exposed to someone with fifth disease (rash illness in a child).
  • Mention if you work with young children and there is an outbreak.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • You have been exposed to someone with fifth disease (rash illness in a child)
  • You work with young children and there is an outbreak
  • You develop a rash, joint pain, or flu-like symptoms after exposure

Urgent signs to report immediately

  • Confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring
  • Ultrasound showing signs of fetal hydrops or anemia

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Bottom line

Most cases of parvovirus b19 (fifth disease) in pregnancy are normal. Talk to your pediatrician if confirmed acute parvovirus infection during pregnancy - specialist referral needed for monitoring.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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