FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 324:1247-1252 May 2, 1991 Number 18 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

BACKGROUND AND METHODS. To define the risk factors associated with neonatal acquisition of herpes simplex virus (HSV) infection, we prospectively obtained HSV cultures from the cervix and external genitalia of 15,923 pregnant women in early labor who were without symptoms or signs of genital HSV infection. Follow-up of the women with positive cultures for HSV and their HSV-exposed infants included serologic tests and serial cultures for HSV. RESULTS. HSV was isolated from 56 of the women (0.35 percent), 18 of whom (35 percent) had serologic evidence of a recently acquired, subclinical first episode of genital HSV infection, and 34 of whom (65 percent) had reactivation of HSV. Neonatal HSV developed in 6 of 18 infants (33 percent) born to the women with a first episode of genital HSV, and in 1 of 34 infants (3 percent) born to the women with reactivation of HSV (P less than 0.01); neonatal HSV also occurred in three of the infants born to the 15,867 women with negative cultures. Neonatal HSV-2 occurred in 1 of 4 infants born to mothers seronegative at delivery for both HSV-1 and HSV-2, in 4 of 12 infants exposed to HSV-2 whose mothers had only HSV-1 antibodies at delivery, and in none of the infants born to 31 women who were HSV-2-seropositive. An increased risk of neonatal HSV was associated with exposure to viral shedding from the cervix and the use of fetal-scalp electrodes. CONCLUSIONS: Of the asymptomatic women who shed HSV in early labor, about a third have recently acquired genital HSV, and their infants are 10 times more likely to have neonatal HSV than those of women with asymptomatic reactivation of HSV. The presence of maternal antibodies specific to HSV-2 but not HSV-1 appears to reduce the neonatal transmission of HSV-2. Further studies are necessary to determine whether screening and prophylactic treatment are warranted for infants of HSV-2-seronegative mothers who shed HSV-1 or HSV-2 in early labor.

Source Information

Department of Obstetrics and Gynecology, University of Washington, Seattle 98195.

This article has been cited by other articles:

• Kasubi, M. J., Nilsen, A., Marsden, H. S., Bergstrom, T., Langeland, N., Haarr, L. (2006). Prevalence of Antibodies against Herpes Simplex Virus Types 1 and 2 in Children and Young People in an Urban Region in Tanzania.. J. Clin. Microbiol. 44: 2801-2807 [Abstract] [Full Text]  
• Sheffield, J. S., Hill, J. B., Hollier, L. M., Laibl, V. R., Roberts, S. W., Sanchez, P. J., Wendel, G. D. Jr (2006). Valacyclovir prophylaxis to prevent recurrent herpes at delivery: a randomized clinical trial.. Obstet Gynecol 108: 141-147 [Abstract] [Full Text]  
• Burgos, J. S., Ramirez, C., Guzman-Sanchez, F., Alfaro, J. M., Sastre, I., Valdivieso, F. (2006). Hematogenous Vertical Transmission of Herpes Simplex Virus Type 1 in Mice. J. Virol. 80: 2823-2831 [Abstract] [Full Text]  
• Brown, Z. A., Gardella, C., Wald, A., Morrow, R. A., Corey, L. (2005). Genital Herpes Complicating Pregnancy. Obstet Gynecol 106: 845-856 [Abstract] [Full Text]  
• Kimberlin, D. W. (2004). Neonatal Herpes Simplex Infection. Clin. Microbiol. Rev. 17: 1-13 [Abstract] [Full Text]  
• Sheffield, J. S., Hollier, L. M., Hill, J. B., Stuart, G. S., Wendel, G. D. Jr (2003). Acyclovir Prophylaxis to Prevent Herpes Simplex Virus Recurrence at Delivery: A Systematic Review. Obstet Gynecol 102: 1396-1403 [Abstract] [Full Text]  
• Adair, C. E., Kowalsky, L., Quon, H., Ma, D., Stoffman, J., McGeer, A., Robertson, S., Mucenski, M., Davies, H. D. (2003). Risk factors for early-onset group B streptococcal disease in neonates: a population-based case-control study. CMAJ 169: 198-203 [Abstract] [Full Text]  
• Gorander, S., Svennerholm, B., Liljeqvist, J.-A. (2003). Secreted Portion of Glycoprotein G of Herpes Simplex Virus Type 2 Is a Novel Antigen for Type-Discriminating Serology. J. Clin. Microbiol. 41: 3681-3686 [Abstract] [Full Text]  
• Bentley, J. M., Barankin, B., Guenther, L. C. (2003). A Review of Common Pediatric Lip Lesions: Herpes Simplex/Recurrent Herpes Labialis, Impetigo, Mucoceles, and Hemangiomas. CLIN PEDIATR 42: 475-482 [Abstract]  
• Fisman, D N, Hook, E W III, Goldie, S J (2003). Estimating the costs and benefits of screening monogamous, heterosexual couples for unrecognised infection with herpes simplex virus type 2. Sex. Transm. Infect. 79: 45-52 [Abstract] [Full Text]  
• Brown, Z. A., Wald, A., Morrow, R. A., Selke, S., Zeh, J., Corey, L. (2003). Effect of Serologic Status and Cesarean Delivery on Transmission Rates of Herpes Simplex Virus From Mother to Infant. JAMA 289: 203-209 [Abstract] [Full Text]  
• Koelle, D. M., Corey, L. (2003). Recent Progress in Herpes Simplex Virus Immunobiology and Vaccine Research. Clin. Microbiol. Rev. 16: 96-113 [Abstract] [Full Text]  
• Barnabas, R V, Carabin, H, Garnett, G P (2002). The potential role of suppressive therapy for sex partners in the prevention of neonatal herpes: a health economic analysis. Sex. Transm. Infect. 78: 425-429 [Abstract] [Full Text]  
• Koi, H., Zhang, J., Makrigiannakis, A., Getsios, S., MacCalman, C. D., Strauss, J. F. III, Parry, S. (2002). Syncytiotrophoblast Is a Barrier to Maternal-Fetal Transmission of Herpes Simplex Virus. Biol. Reprod. 67: 1572-1579 [Abstract] [Full Text]  
• Workowski, K. A., Levine, W. C., Wasserheit, J. N. (2002). U.S. Centers for Disease Control and Prevention Guidelines for the Treatment of Sexually Transmitted Diseases: An Opportunity To Unify Clinical and Public Health Practice. ANN INTERN MED 137: 255-262 [Abstract] [Full Text]  
• Garnett, G P (2002). The geographical and temporal evolution of sexually transmitted disease epidemics. Sex. Transm. Infect. 78: i14-19 [Abstract] [Full Text]  
• Buka, S. L., Tsuang, M. T., Torrey, E. F., Klebanoff, M. A., Bernstein, D., Yolken, R. H. (2001). Maternal Infections and Subsequent Psychosis Among Offspring. Arch Gen Psychiatry 58: 1032-1037 [Abstract] [Full Text]  
• Armstrong, G. L., Schillinger, J., Markowitz, L., Nahmias, A. J., Johnson, R. E., McQuillan, G. M., St. Louis, M. E. (2001). Incidence of Herpes Simplex Virus Type 2 Infection in the United States. Am J Epidemiol 153: 912-920 [Abstract] [Full Text]  
• Drake, S., Taylor, S., Brown, D., Pillay, D. (2000). Regular review: Improving the care of patients with genital herpes. BMJ 321: 619-623 [Full Text]  
• Corey, L., Handsfield, H. H. (2000). Genital Herpes and Public Health: Addressing a Global Problem. JAMA 283: 791-794 [Abstract] [Full Text]  
• Mikloska, Z., Sanna, P. P., Cunningham, A. L. (1999). Neutralizing Antibodies Inhibit Axonal Spread of Herpes Simplex Virus Type 1 to Epidermal Cells In Vitro. J. Virol. 73: 5934-5944 [Abstract] [Full Text]  
• Eis-Hübinger, A. M., Däumer, M., Matz, B., Schneweis, K. E. (1999). Evaluation of Three Glycoprotein G2-Based Enzyme Immunoassays for Detection of Antibodies to Herpes Simplex Virus Type 2 in Human Sera. J. Clin. Microbiol. 37: 1242-1246 [Abstract] [Full Text]  
• Ashley, R. L., Wald, A. (1999). Genital Herpes: Review of the Epidemic and Potential Use of Type-Specific Serology. Clin. Microbiol. Rev. 12: 1-8 [Abstract] [Full Text]  
• Brown, Z. A., Selke, S., Zeh, J., Kopelman, J., Maslow, A., Ashley, R. L., Watts, D. H., Berry, S., Herd, M., Corey, L. (1997). The Acquisition of Herpes Simplex Virus during Pregnancy. NEJM 337: 509-516 [Abstract] [Full Text]  
• Wald, A., Zeh, J., Selke, S., Ashley, R. L., Corey, L. (1995). Virologic Characteristics of Subclinical and Symptomatic Genital Herpes Infections. NEJM 333: 770-775 [Abstract] [Full Text]