Congenital rubella

Congenital rubella is a group of physical abnormalities that occur in an infant as a result of infection of the mother with rubella virus.

Causes, incidence, and risk factors

Congenital rubella is caused by the destructive action of the rubella virus on the fetus at a critical time in development. The most critical time is the first trimester (the first 3 months of a pregnancy). After the 4th month, maternal rubella infection is less likely to harm the developing fetus.

The incidence of rubella syndrome has decreased dramatically since the advent of rubella vaccine.

Risk factors include lack of the recommended rubella immunization and contact with a person who has rubella. Non-immunized, non-immune pregnant women are at risk for infection and subsequent damage to the fetus.


  • History of mother having rubella while pregnant (particularly in the first trimester)  
  • Skin rash at birth (purpura, petechiae)  
  • Low birth weight  
  • Small head size (microcephaly)  
  • Lethargy  
  • Irritability  
  • Deafness  
  • Seizures  
  • Cloudy corneas or white appearance to pupil (leukocoria)  
  • Developmental delay  
  • Mental retardation

Signs and tests

Eye findings:

  • Cataracts  
  • Glaucoma  
  • Retinitis

Congenital heart disease findings:

  • Patent ductus arteriosus (PDA)  
  • Pulmonary artery stenosis  
  • Other heart defects

Central nervous system findings:

  • Mental retardation  
  • Motor retardation  
  • Small head (microcephaly) from failed brain development  
  • Encephalitis  
  • Meningitis

Others associated findings:

  • Deafness  
  • Low blood platelet count  
  • Enlarged liver and spleen  
  • Abnormal muscle tone  
  • Bone disease

Tests include:

  • Urine tests, nasopharyngeal secretions tests, or cerebrospinal fluid tests for virus  
  • Antibody tests


There is no specific treatment for rubella syndrome. Care involves appropriate treatment of affected systems in consultation with your health care providers.

Expectations (prognosis)

The prognosis for children with congenital rubella depends on the signs and symptoms present. Some findings, such as heart defects, can be corrected. However, findings such as nervous system damage cannot.


As described above under Signs and Tests and Symptoms.

Calling your health care provider
Call your health care provider if you have concerns about congenital rubella, if you are unsure of your vaccination status, or if you or your child needs rubella vaccine.


Vaccination prior to pregnancy can prevent congenital rubella. Pregnant women who are non-immune should avoid contact with persons with rubella.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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