The acquisition of herpes simplex virus during pregnancy
The acquisition of herpes simplex virus during pregnancy
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DOI：
10.1056/nejm199708213370801
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发表时间：
1997-08-21
影响因子：
158.5
通讯作者：
Corey, L
中科院分区：
文献类型：
--
作者：
Brown, ZA;Selke, S;Corey, L
妊娠期生殖器疱疹的发生与自然流产、早产、先天性和新生儿疱疹有关。血清转换的频率，母亲的疾病症状，其对妊娠结局的最大影响的时间没有被系统地studyed.Methods我们研究了7046名孕妇的血清学试验表明，在单纯疱疹病毒（HSV）感染的风险。在第一次产前访视时，在大约16和24周时，以及在分娩过程中获得的血清样品用于HSV 1型和2型抗体的检测结果94例孕妇血清HSV-1、HSV-2阳性; 94名妇女中有34名（36%）有与疱疹感染一致的症状。最初对HSV-1和HSV-2均呈血清阴性的妇女，估计任何一种病毒的血清转化机会为3.7%;最初仅对HSV-1呈血清阳性的妇女，估计HSV-2血清转化机会为1.7%;最初HSV-2血清阳性的妇女，估计获得HSV-1感染的机会为零。在94例妊娠中的60例中，HSV感染的时间是已知的，30%的感染发生在妊娠早期，30%发生在妊娠中期，40%发生在妊娠晚期。在分娩时完成HSV血清转换与新生儿发病率增加或任何先天性疱疹感染病例无关。然而，在出生的婴儿9名妇女谁获得生殖器HSV感染前不久，新生儿HSV感染发生在4个婴儿，其中1人死亡。结论2%或更多的易感妇女获得HSV感染在怀孕期间。在分娩前完成血清转换的感染似乎不影响妊娠结局，但在分娩前后获得的感染与新生儿疱疹和围产期发病率相关。(C)1997年，马萨诸塞州医学会。
Background The acquisition of genital herpes during pregnancy has been associated with spontaneous abortion, prematurity, and congenital and neonatal herpes. The frequency of seroconversion, maternal symptoms of the disease, and the timing of its greatest effect on the outcome of pregnancy have not been systematically studied.Methods We studied 7046 pregnant women whom serologic tests showed to be at risk for herpes simplex virus (HSV) infection. Serum samples obtained at the first prenatal visit, at approximately 16 and 24 weeks, and during labor were tested for antibodies to HSV types 1 and 2 (HSV-1 and HSV-2) by the Western blot assay, and the results were correlated with the occurrence of antenatal genital infections.Results Ninety-four of the women became seropositive for HSV; 34 of the 94 women (36 percent) had symptoms consistent with herpes infection. Women who were initially seronegative for both HSV-1 and HSV-2 had an estimated chance of seroconversion for either virus of 3.7 percent; those who were initially seropositive only for HSV-1 had an estimated chance of HSV-2 seroconversion of 1.7 percent; and those who were initially HSV-2-seropositive had an estimated chance of zero for acquiring HSV-1 infection. Among the 60 of the 94 pregnancies for which the time of acquisition of HSV infection was known, 30 percent of the infections occurred in the first trimester, 30 percent in the second, and 40 percent in the third. HSV seroconversion completed by the time of labor was not associated with an increase in neonatal morbidity or with any cases of congenital herpes infection. However, among the infants born to nine women who acquired genital HSV infection shortly before labor, neonatal HSV infection occurred in four infants, of whom one died.Conclusions Two percent or more of susceptible women acquire HSV infection during pregnancy. Acquisition of infection with seroconversion completed before labor does not appear to affect the outcome of pregnancy, but infection acquired near the time of labor is associated with neonatal herpes and perinatal morbidity. (C) 1997, Massachusetts Medical Society.