Perinatal risk associated with maternal genital herpes simplex virus infection

Nahmias, A. J.; Josey, William E.; Naib, Zuher M.; Freeman, Malcolm G.; Fernandez, Raymond J.; Wheeler, Jenette H.

doi:10.1016/0002-9378(71)90580-1

Cited by 393 publications

(114 citation statements)

References 10 publications

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“…Factors influencing neonatal transmission. Factors that influence transmission from mother to neonate include the type of maternal infection (primary versus recurrent) (21,23,24,28,62), maternal antibody status (24,70,104,105), duration of rupture of membranes (62), integrity of mucocutaneous barriers (e.g., use of fetal scalp electrodes) (24,41,67), and mode of delivery (cesarean section versus vaginal) (24).…”

Section: Maternal Genital Infectionsmentioning

confidence: 99%

Neonatal Herpes Simplex Infection

2004

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Tremendous advances have occurred over the past 30 years in the diagnosis and management of neonatal herpes simplex virus (HSV) disease. Mortality in patients with disseminated disease has decreased from 85 to 29%, and that in patients with central nervous system (CNS) disease has decreased from 50 to 4%. Morbidity has been improved more modestly: the proportion of patients with disseminated disease who are developing normally at 1 year has increased from 50 to 83%. While the proportion of patients with neurologic morbidity following CNS disease has remained essentially unchanged over the past three decades, the total number of patients who are developing normally following HSV CNS disease has increased due to the improved survival. Although additional therapeutic advances in the future are possible, more immediate methods for further improvements in outcome for patients with this potentially devastating disease lie in an enhanced awareness of neonatal HSV infection and disease. A thorough understanding of the biology and natural history of HSV in the gravid woman and the neonate provides the basis for such an index of suspicion and is provided in this article

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Section: Maternal Genital Infectionsmentioning

confidence: 99%

Neonatal Herpes Simplex Infection

2004

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“…In about half of the cases in which the baby becomes infected, maternal infection is not suspected (4,14). Data accumulated by Nahmias et al suggest that the risk of infection in infants exposed to HSV during vaginal delivery is less if the maternal infection is recurrent (4%) than if it is primary (50%) (13). The difference in prognosis for infants of mothers with recurrent infections as compared with those with primary infections may be related to the location and quantity of virus present and to the quantity of maternally derived antibody acquired by the infant.…”

mentioning

confidence: 99%

Relationship of Antibody to Outcome in Neonatal Herpes Simplex Virus Infections

Yeager

Arvin

Urbani

et al. 1981

Obstetrical & Gynecological Survey

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Neutralizing antibody titers to herpes simplex virus type 1 (HSV-1) and HSV-2 were measured at birth in normal infants and uninfected infants of mothers with genital HSV infections during pregnancy and at the onset of infection in 5 infants with mild infections and 11 infants with severe infections. Thirty-eight percent of premature and 29% of term infants had neutralization titers of <1:5. High titers (,1:40) were found in 55% of infants of mothers with primary infections during pregnancy and in 76% of infants of mothers with recurrent infections. The mean titers to HSV-1 and -2 in 5 infected infants with mild infections were 1:56 and 1:65 at the time of onset of infection, whereas the mean titers in 11 infants with severe infections were 1:11 and 1:12. Six natally exposed infants who remained asymptomatic were also studied and had a mean titer to HSV-1 of 1:85 and to HSV-2 of 1:69. Therefore, infants with high titers of transplacentally derived antibody had a more favorable outcome than infants with lower titers. Ninety-five percent of the infants of mothers with recurrent infections had a Rawls index of more than 85, suggesting that the antibody response was to HSV-2. However, low levels of antibody with this type specificity failed to protect four infants from infection with HSV-2. Augmentation of the neutralization titer to HSV-2 by the amount of complement present in cord serum was less than twofold. The study suggests that the quantity of antibody derived transplacentally affects the outcome of infection after natal exposure to herpes simplex virus. Complete neutralization of virus by antibody may occur in some infants, and prolongation of the incubation period and modification of the infection may occur in others.Genital infections due to herpes simplex virus (HSV) are among the most common venereal diseases identified in patients from middle and upper socioeconomic groups (3, 7). The incidence of natally acquired HSV infections appears to be increasing (L. Corey, personal communication). In about half of the cases in which the baby becomes infected, maternal infection is not suspected (4,14). Data accumulated by Nahmias et al. suggest that the risk of infection in infants exposed to HSV during vaginal delivery is less if the maternal infection is recurrent (4%) than if it is primary (50%) (13). The difference in prognosis for infants of mothers with recurrent infections as compared with those with primary infections may be related to the location and quantity of virus present and to the quantity of maternally derived antibody acquired by the infant. Adams et al. found that virus was present on the cervix in 87% of women with primary infections but in only 4% of those with recurrent infections (1). The presence of virus high in the birth canal in contrast to the exterior of the labia majora, the usual site for recurrent lesions, might also influence morbidity, since inoculation of the baby from a labial lesion might occur less often than from a cervical lesion. HSV is shed in greater quantities and for l...

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“…Studies by Nahmias et al (1971) and Whitley et al (1980) revealed that there was no difference in the frequency of disease caused by HSV between human neonates with transplacentally acquired antibody and those without antibody. However, Yeager et al (1980) pointed out that neonates with high titres of neutralizing antibody have a more favourable prognosis than neonates with low antibody titres.…”

Section: Discussionmentioning

confidence: 99%

“…Herpes simplex virus (HSV) causes fatal, disseminated infection in newborn humans (Nahmias et al, 1971 ;Hanshow, 1973;Whitley et al, 1980) and mice (Johnson, 1964;Hirsch et al, 1970;Kern et al, 1973). Concerning the influence of maternally derived antibody in protection against human neonatal HSV infection, several reports have revealed conflicting estimations of its importance (Nahmias et al, 1971 ;Whitley et al, 1980;Yeager et al, 1980).…”

Section: Introductionmentioning

confidence: 99%

“…Concerning the influence of maternally derived antibody in protection against human neonatal HSV infection, several reports have revealed conflicting estimations of its importance (Nahmias et al, 1971 ;Whitley et al, 1980;Yeager et al, 1980). In animal studies, mice born to immunized mothers were somewhat resistant to HSV infection (Berry & Slavin, 1943;Amstey & Kobos, 1976).…”

Section: Introductionmentioning

confidence: 99%

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