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Varicella pneumonia is the major cause of maternal mortality associated with varicella during pregnancy due to the severe respiratory complications it can cause. Pregnant individuals are at increased risk for developing serious complications from varicella infection because of the physiological changes that occur during pregnancy, particularly in terms of immune system function and lung capacity.

When varicella leads to pneumonia, it can result in significant respiratory distress and impair oxygen exchange, which can be life-threatening. Pneumonia caused by varicella is characterized by rapid onset and can progress severely, especially in the second and third trimesters. Given the potential for viral illness to exacerbate underlying respiratory conditions or to lead to secondary bacterial infections, it places pregnant people at a high risk for complications that can ultimately lead to maternal mortality.

Understanding varicella's impact on pregnancy is essential for healthcare providers, as they must recognize the signs and symptoms early and manage the condition aggressively to minimize risks to both the mother and fetus. In contrast, other options, while they may involve aspects of varicella infection, do not carry the same level of risk of maternal mortality in the context of pregnancy as varicella pneumonia does.