Unusual high rate of asymptomatic maternal parvovirus B19 infection associated with severe fetal outcome

Abstract

Asymptomatic parvo B19 infection is associated with poor fetal outcome much more than we presumed previously.

Parvovirus B19 in pregnancy

“…In case of a maternal infection, transmission to the fetus occurs in one third to one half of cases, with a risk of adverse fetal outcome of about 10% [13,[18][19][20][21]22 & ,23]. Brkic et al [24] recently analyzed 176 pregnancies for asymptomatic B19V infection, and found a significantly higher prevalence of B19V in second trimester women with symptoms of miscarriage as compared to uncomplicated controls. The risk of fetal complications is believed to be greatest when infection occurs in the first 22 weeks of pregnancy [25].…”

Recent parvovirus B19 infection in late pregnancy

“…B19V usually causes a mild, self‐limiting, and exanthematous disease in childhood; it can cause cytopenia in immunocompromised hosts and intrauterine fetal death in pregnant women with primary infection [1]. Infection usually takes place through respiratory droplets but the virus can also be transmitted by blood and vertically from mother to fetus [2].…”

Parvovirus B19 Infections in Pregnant Women and Neonates: Review

“…33 Brkic found asymptomatic acute parvovirus B19 infection rate as 22.72% among pregnant women with spontaneous abortion. 26 On the other hand, Enders et al reported fetal hydrops risk as 4.2% after gestational parvovirus B19 infection. 34 Gratacos et al reported the incidence of acute infection during pregnancy as 3.7% and the incidence of fetal loss caused by parvovirus as 1.66%.…”

“…In the third semester, fetal death is reported in approximately 7% of infected pregnant women. 25,26 Fetal and maternal infection can also be asymptomatic. 25,27 When a pregnant woman has acute parvovirus B19 infection, the transmission rate to fetus is about 33%, and the risk for fetal death is 9%.…”

“…10,45 However, it is suggested that, significant viral load in cord blood or amniotic fluid is not predictive to poor outcome of pregnancy. 3,26 Most of the fetal complications occur within the 8-12 weeks of maternal parvovirus B19 infection. 10,24 Weekly USG follow-up is recommended for at least 12 weeks of a pregnant woman with a history of exposure or parvovirus B19 infection.…”