Abstract
In spite of a greater awareness and current obstetrical practices, the incidence of neonatal HSV is increasing. The mothers of 50-70% of these infants have no hx of genital HSV, yet serology usually implies asymptomatic (ASX) HSV2 infection. We prospectively studied 231 pregnant middle & upper SES women with no hx of genital HSV to determine the prevalence and risk factors of ASX HSV2 and the rate of genital tract shedding of HSV at delivery. We assessed Ab to HSV1 and 2 in prenatal sera by western blot, and risk factors for HSV2 infection by questionnaires. HSV2 Ab was detected in 79/231 (34%) of the women. Seropositivity was associated with a hx of ≥6 sexual partners, TABs, other STDs and yeast vaginitis (p<.05); while age, age at first sexual intercourse, a hx or present sexual partner with genital HSV was not significantly associated with HSV2 Ab. A first episode of clinical HSV developed during pregnancy in 7/43 ASX HSV2 seropositive women who have delivered; 5 occurred close to term and were delivered by C/S. ASX shedding of HSV2 was detected in an additional woman 4 wks prior to delivery with negative weekly cultures subsequently. Among the remaining 35 ASX seropositive women, 178 viral cultures during the last 6 wks of pregnancy or at delivery were negative. The high prevalence of HSV2 Ab in this ASX pregnant population stresses the importance of further assessing the risk of viral shedding and potential transmission of HSV to the infants.
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Frenkel, I., Shen, J., Garratty, E. et al. A PROSPECTIVE STUDY OF PREGNANT WCMEN TO DETERMINE PREVALENCE AND RISK FACTORS OF ASYMPTOMATIC INFECTION WITH HERPES SIMPLEX VIRUS (HSV) TYPE 2 AND THE RISK OF SHEDDING VIRUS AT DELIVERY. Pediatr Res 21 (Suppl 4), 325 (1987). https://doi.org/10.1203/00006450-198704010-00946
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DOI: https://doi.org/10.1203/00006450-198704010-00946