Zika Virus and Pregnancy: A Complete Guide to Risks, Prevention, and Care
Learn about the risks of Zika virus during pregnancy, essential prevention strategies, and specialised prenatal care to protect both mother and baby.
Written by Dr. Shaik Abdul Kalam
Reviewed by Dr. D Bhanu Prakash MBBS, AFIH, Advanced certificate in critical care medicine, Fellowship in critical care medicine
Last updated on 9th Oct, 2025
Introduction
Pregnancy is a time of joy and anticipation, but it also requires being extra vigilant about health risks. One virus that gained global attention for its profound impact on pregnancy is the Zika virus. Understanding the connection between the Zika virus and pregnancy is crucial for any expectant parent or anyone planning a family. This guide will walk you through everything you need to know—from how the virus is transmitted and the real risks it poses to your baby, to the essential steps you can take for prevention and the specialised prenatal care recommended if you've been exposed. Our goal is to empower you with clear, actionable information to help you navigate this concern confidently.
What is the Zika Virus?
The Zika virus is a mosquito-borne illness that was first identified in Uganda in 1947. For decades, it caused only sporadic, mild cases. However, a major outbreak in the Americas in 2015 revealed its devastating potential when contracted during pregnancy. The virus itself is a flavivirus, related to dengue, yellow fever, and West Nile virus. While often causing no or mild symptoms in adults, its ability to cross the placenta and infect a developing foetus is what makes it a serious public health concern.
How is Zika Virus Transmitted?
Knowing how Zika spreads is the first step in prevention. There are three primary routes of transmission relevant to expectant mothers.
Mosquito Bites: The Primary Vector
The most common way to get Zika is through the bite of an infected Aedes species mosquito, primarily Aedes aegypti. These are the same mosquitoes that spread dengue and chikungunya. They are aggressive daytime biters, but they can also bite at night. This mode of transmission is most prevalent in tropical and subtropical regions.
Sexual Transmission: A Critical Concern for Partners
Zika can be passed through unprotected sex (vaginal, anal, and oral) with a partner who has been infected, even if that person never showed symptoms of Zika. The virus can remain in semen for months longer than in blood. This is a critical consideration if a pregnant woman’s partner has traveled to an area with a risk of Zika.
Mother-to-Child Transmission During Pregnancy
This is the most concerning transmission route. A pregnant woman infected with Zika can pass the virus to her foetus during pregnancy or around the time of birth. This vertical transmission is directly linked to severe birth defects linked to Zika.
Common Symptoms of Zika Virus Infection
It's important to note that only about 1 in 5 people infected with the Zika virus will become ill. When symptoms do occur, they are usually mild and last for several days to a week. The most common symptoms of Zika in pregnancy (and in general) include:
Fever
Rash
Joint pain (especially in the hands and feet)
Conjunctivitis (red eyes)
Muscle pain
Headache
Because these symptoms are similar to other illnesses, it’s easy to mistake Zika for a common cold or flu. If you are pregnant and experience these symptoms after potential exposure, it is essential to consult your doctor. If you're unsure about your symptoms, you can consult a doctor online with Apollo24|7 for an initial evaluation.
Consult an Obstetrician-Gynaecologist for the best advice
The Critical Link Between Zika and Pregnancy
The central reason Zika is a major concern is its direct link to a pattern of severe birth defects known as Congenital Zika Syndrome (CZS). Infection during any trimester poses a risk, but the first trimester appears to be a period of particularly high vulnerability for the developing brain.
Understanding Congenital Zika Syndrome
Congenital Zika Syndrome is a unique pattern of birth defects found in foetuses and infants infected with Zika before birth. It represents the most severe end of the spectrum of effects. Not all babies exposed to Zika will have CZS, but the consequences can be life-altering, involving significant challenges with development, learning, and movement.
Specific Birth Defects Linked to Zika
The most well-known defect is microcephaly, a condition where a baby’s head is much smaller than expected, often due to the brain not developing properly. However, Zika-related brain defects can occur even without microcephaly. Other serious problems include:
Brain calcium deposits: Damage to brain tissue that shows up as calcification on scans.
Eye abnormalities: These can affect vision.
Joint limitations: Such as clubfoot, due to problems with nerve and muscle development.
Hypertonia: Restricted body movement soon after birth due to increased muscle tone.
Essential Prevention Strategies for Expectant Mothers
Since there is no vaccine or specific treatment for Zika, prevention is the absolute cornerstone of protecting yourself and your baby. A proactive approach is necessary.
Travel Considerations and Advisories
The most effective way to prevent Zika is to avoid travel to areas with active Zika transmission. The CDC and WHO regularly update their travel advisories for Zika areas. If you are pregnant or trying to conceive, it is strongly recommended to postpone non-essential travel to these regions. Check the latest guidelines before making any travel plans.
Protecting Yourself from Mosquito Bites
If you live in or must travel to an area with mosquitoes that carry Zika, rigorous bite prevention is key.
Use EPA-registered insect repellents: Products containing DEET, picaridin, or oil of lemon eucalyptus are safe and effective during pregnancy when used as directed.
Wear protective clothing: Long-sleeved shirts, long pants, socks, and hats.
Use physical barriers: Stay in places with air conditioning or window/door screens. Use a mosquito bed net if sleeping outdoors or in unscreened rooms.
Safe Sexual Practices During Pregnancy
If your partner has traveled to or lives in a Zika area, you must take precautions to prevent sexual transmission.
Use condoms correctly every time you have vaginal, anal, or oral sex for the entire duration of the pregnancy.
Abstaining from sex is the only way to be 100% sure of avoiding sexual transmission.
The recommended period for these precautions depends on whether your partner shows symptoms. It's best to discuss this with your healthcare provider for personalised advice.
Diagnosis and Testing for Zika Virus
If you are pregnant and may have been exposed to Zika, prompt testing is crucial for managing your prenatal care.
Who Should Be Tested?
Testing is recommended for:
Pregnant women who have traveled to an area with Zika risk, regardless of whether they have symptoms.
Pregnant women whose sexual partner has traveled to a Zika-risk area.
Pregnant women showing possible symptoms of Zika virus infection.
Types of Zika Virus Tests Available
Diagnosis typically involves molecular tests (like RT-PCR) that look for the virus's genetic material in blood or urine, and serologic tests (IgM) that look for antibodies the body makes to fight the infection. Interpretation can be complex due to potential cross-reactivity with other viruses like dengue. Apollo24|7 offers convenient home collection for a wide range of tests, and your doctor can guide you on the appropriate course of action.
Prenatal Care and Management if Exposed
A potential Zika exposure requires a specialised approach to prenatal care for a Zika-exposed pregnancy.
Enhanced Ultrasound Monitoring
If you test positive or have inconclusive results, your doctor will recommend a series of detailed ultrasounds to closely monitor the foetus's growth and brain development. These scans, typically performed every 3-4 weeks, look for signs of microcephaly, calcium deposits, and other abnormalities.
Consulting with a Maternal-Foetal Medicine Specialist
You may be referred to a maternal-foetal medicine (MFM) specialist, an obstetrician with expertise in high-risk pregnancies. They can coordinate your care, interpret complex ultrasound findings, and discuss the potential outcomes and options with you.
Planning a Pregnancy After Potential Zika Exposure
For couples trying to conceive after Zika exposure, following waiting periods is critical to ensure the virus has cleared from the body.
Recommended Waiting Periods
Current guidelines suggest:
Women with possible Zika exposure: Wait at least 2 months after symptoms start or last possible exposure before trying to conceive.
Men with possible Zika exposure: Wait at least 3 months after symptoms start or last possible exposure. This longer period is due to the virus persisting longer in semen.
These timelines are conservative estimates designed to minimise risk. It's best to have a preconception consultation with your doctor to discuss your specific situation.
Conclusion
Navigating the risks of the Zika virus and pregnancy can feel overwhelming, but knowledge is your best defense. The key takeaways are the profound importance of prevention through informed travel choices, rigorous protection from mosquito bites, and safe sexual practices. If exposure does occur, timely testing and specialised prenatal monitoring are essential for managing the pregnancy and preparing for any potential outcomes. While the link to birth defects is serious, remember that infection does not automatically mean your baby will be affected. Open communication with your healthcare provider is vital. By staying informed and taking proactive steps, you can significantly reduce the risks and focus on the healthiest possible outcome for you and your baby.
Consult an Obstetrician-Gynaecologist for the best advice
Consult an Obstetrician-Gynaecologist for the best advice
Dr. Mona Yadav
Obstetrician and Gynaecologist
19 Years • MBBS, MD (Obstetrics & Gynaecology)
Dombivli
Nulife multispeciality, Dombivli
Dr. Parul Sharma
Obstetrician and Gynaecologist
8 Years • MBBS, MS (Obstetrics & Gynaecology)
New Delhi
THE DOCTORS NESST, New Delhi
Dr. Asha Rani Singh
Obstetrician and Gynaecologist
24 Years • MBBS DGO
Delhi
Dr Asha Rani Singh Clinic, Delhi
Dr. K Anusha
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4 Years • MBBS, DGO
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SRINIVASAA HOSPITAL, Yemmiganur
Dr. Shyamala Devi
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38 Years • MBBS, MS Obstetrics & Gynaecology
Vijayawada
Sri Shivshakti Nilayam, Vijayawada
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Frequently Asked Questions
1. Can Zika affect a pregnancy in the third trimester?
Yes, while the risk of severe brain defects is highest in the first trimester, infection later in pregnancy can still cause issues, such as foetal growth restriction or other neurological problems. Continuous vigilance is important.
2. What are the long-term effects of congenital Zika syndrome?
Children with CZS may face a range of challenges, including seizures, hearing and vision problems, difficulties with movement and coordination, and delayed developmental milestones. They require long-term, multidisciplinary care.
3. Is it safe to use insect repellent containing DEET during pregnancy?
Yes, according to the CDC and ACOG, EPA-registered insect repellents, including those with DEET, picaridin, and IR3535, are safe and effective for use during pregnancy when applied according to the product label instructions.
4. How accurate are Zika virus tests?
Molecular tests (RT-PCR) are very accurate if done while the virus is still in the blood or urine (within the first 1-2 weeks of infection). Antibody tests (IgM) can be less specific and may cross-react with similar viruses like dengue, sometimes requiring additional confirmatory testing.
5. If I had Zika once, am I immune to future pregnancies?
Current evidence suggests that once a person has been infected with Zika, they are likely to be protected from future infections. This is believed to confer lifelong immunity.