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Pediatría (Asunción)

On-line version ISSN 1683-9803

Abstract

SAMUDIO DOMINGUEZ, Gloria Celeste; BENITEZ, Rocío; CARRERAS, Dina Carmen  and  ORTIZ CUQUEJO, Lidia María. Characteristics of newborns born to mothers with positive IgM for Herpes simplex virus. Pediatr. (Asunción) [online]. 2024, vol.51, n.1, pp.49-57. ISSN 1683-9803.  https://doi.org/10.31698/ped.51012024007.

Introduction:

neonatal herpes is a rare entity associated with high morbidity and mortality. The probability of transmission to the newborn ranges from 5% to 85%. The diagnosis is difficult due to the lack of clinical signs, unreliable serology and the non-availability of PCR in public services in developing countries. IgM in pregnant women could be used as a suspected marker to evaluate the neonate.

Objective:

To characterize newborn children of pregnant women with positive IgM for HSV 1-2 and the prevalence of encephalitis in infants.

Materials and methods:

Observational, descriptive, prospective study, carried out from May 2020 to October 2021. Newborns (NB) of mothers with positive IgM for Herpes Virus Simplex (HSV) from the second half of pregnancy were included. In newborns, IgG and IgM were performed, and in addition, PCR-RT for HSV 1-2 in blood and/or CSF, excluding those born in other hospitales and/or without maternal serology data.

Results:

We included 36 patients. Maternal age was 28 years (DS + 4), 5% with a history of HSV. 61% were delivered via cesarean section, 36% were premature, 13% had IUGR. 22% of the newborns had acute symptoms. 19% had thrombocytopenia, 44% had GOT alteration. 63% were PCR positive for HSV in serum and 44% were CSF-positive. Hemorrhage, hydrocephalus and leukomalacia were found in 27%. No differences were found in clinical expression by type of delivery.

Conclusions:

Newborns born to pregnant women with positive IgM for HSV from the second half of pregnancy or peripartum, presented HSV infection as determined by PCR in blood or CSF, regardless of the route of delivery. Serological diagnosis in pregnant women allows early screening, diagnosis and treatment of the NB.

Keywords : Neonatal Herpes Simplex Virus infection; herpes encephalitis; maternal serological screening.

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