Mpox Cases Among Cisgender Women and Pregnant Persons — United States, May 11–November 7, 2022

United States, May 11-November 7, 2022

Lisa P. Oakley, PhD; Kaitlin Hufstetler, MD; Jesse O'Shea, MD; J. Danielle Sharpe, PhD; Cristin McArdle, PhD; Varsha Neelam, MPH; Nicole M. Roth, MPH; Emily O. Olsen, PhD; Maren Wolf, MPH; Leah Zilversmit Pao, PhD; Jeremy A. W. Gold, MD; K. Meryl Davis, MD; Dana Perella, MPH; Shara Epstein, MD; Maura K. Lash, MPH; Olivia Samson, MPH; Jessica Pavlick, DrPH; Amanda Feldpausch, DVM; Jennifer Wallace, MD; Atmaram Nambiar, MD; Van Ngo, MPH; Umme-Aiman Halai, MD; Claudia W. Richardson, MD; Traci Fowler, DNP; Burnestine P. Taylor, MD; Joyce Chou, MSPH; Lindsey Brandon, MSN; Rose Devasia, MD; Erin K. Ricketts, MD; Catherine Stockdale; Mellisa Roskosky, PhD; Rachel Ostadkar; Yeng Vang; Romeo R. Galang, MD; Kiran Perkins, MD; Melanie Taylor, MD; Mary Joung Choi, MD; Paul J. Weidle, PharmD; Patrick Dawson, PhD; Sascha Ellington, PhD


Morbidity and Mortality Weekly Report. 2023;72(1):9-14. 

In This Article

Cases in Currently and Recently Pregnant Persons

During May 11–November 7, 2022, 23 cases of mpox were reported during pregnancy (21) or within 3 weeks of pregnancy (two); all pregnant and recently pregnant persons with mpox identified as cisgender women on the mpox case report form††† (Table 1). Among 12 currently or recently pregnant persons with available exposure data, nine reported sexual contact and three reported household contact. Among 10 cases in pregnant persons with information on trimester of infection, three occurred during the first, four during the second, and three during the third trimester (Table 3). Rash was present in all persons. Genital lesions were reported by four currently or recently pregnant persons; none reported genital lesions near the time of delivery.

Eleven (48%) pregnant persons received tecovirimat (administered during all trimesters of pregnancy); no medication-related adverse events were reported. Four pregnant persons were hospitalized related to symptoms from Monkeypox virus infection (pain control and treatment of superimposed cellulitis) and remained pregnant at discharge. No pregnant person required intensive care, intubation, or unplanned delivery. None of the pregnant persons received vaccinia immune globulin intravenous (VIGIV) for treatment.Of the 21 persons who received an mpox diagnosis during pregnancy, three have reported outcomes, including two full-term deliveries without complications (including no transmission to the infant) and one spontaneous abortion at 11 weeks' gestation. Two pregnant persons experienced mpox symptoms within 3 days after delivery; their newborns developed lesions within 1 week of their symptom onset. Both newborns received oral tecovirimat within 48 hours of developing lesions and were treated for 10–14 days; one received VIGIV. Both newborns responded to treatment, appeared to be in good health, and were discharged home.

One recently pregnant person who was breastfeeding developed lesions 4 days postpartum, including under the breast; this person's newborn developed symptoms with lesions on the face and chest 6 days later. Two other cisgender women who were not pregnant or recently pregnant were breastfeeding at the time of mpox diagnosis. One woman's infant was exposed to a symptomatic household contact; she experienced symptoms 2 weeks after the infant's diagnosis. The second woman received an mpox diagnosis following an occupational exposure; breast milk samples from this person were tested and were negative for Monkeypox virus DNA by polymerase chain reaction testing.§§§

†††CDC recognizes that not all pregnant persons are cisgender women. However, in the study, all cases of mpox in pregnant persons, recently pregnant persons, and breastfeeding persons occurred in persons who identified as cisgender women based on the mpox case report form.
§§§This breastfeeding mother was a health care worker who cared for a symptomatic patient. She later developed atypical features of mpox.