DURHAM, N.C. (WNCN) — A Duke University doctor is among health experts publishing an advisory on monkeypox in pregnancy.

The advisory says it unknown if being pregnant makes a person more susceptible to a monkeypox infection. However, previous outbreaks show an infection is likely to create a higher risk pregnancy.

The Society for Maternal-Fetal Medicine looked at five pregnancies during previous outbreaks. Of those two resulted in spontaneous abortion, one resulted in stillbirth and one resulted in the preterm birth of a neonate with congenital monkeypox infection and subsequent neonatal death.

Dr. Brenna Hughes, vice chair for obstetrics and quality at Duke University and one of the authors on the advisory from Society for Maternal-Fetal Medicine, said just looking at five cases doesn’t give experts a full picture of the implications of monkeypox on pregnancy.

“It is definitely not enough and so much of what you’re seeing here is not based on data or trials at all, and what we have done is develop expert opinion based on prior experience with these five cases that are reported in the literature,” Hughes said.

We do know however that immune systems change during pregnancy creating making any kind of infection more dangerous in pregnant people.

“Proceeding with a bit of caution while we gather data and while we see the cases develop is most likely to be protective of people. If we find that’s actually pretty mild- that would be great but we rather be cautious at this point to ensure we’re protecting as much people as possible,” Hughes said.

There are treatments and a vaccine available that can be given in pregnancy to protect mom and baby.

“If there is a suspected monkeypox infection, collaborating with their public health authority, the obstetricians and the infectious disease specialists will be very important to ensure we can provide optimal care,” Hughes.

North Carolina has reported 188 cases of monkeypox as of Wednesday evening. Nearly all those are in men. The virus is disproportionately affecting Black men who make up about 70 percent of cases so far- but the virus can infect anyone through close contact.

“People who assume that infection is restricted to men who have sex with men is not really accurate,” said Hughes.

She expects the virus will eventually spread to other populations.

“Sometimes we see that more socially vulnerable women actually end up at highest risk for these types of infections because people are not prepared for them to have this kind of infection,” Hughes.

For information on testing and vaccines for monkeypox, click here.