Portal de Periódicos da CAPES

Varicella zoster virus infection in pregnancy.

1993; BMJ; Volume: 68; Issue: 1 Spec No Linguagem: Inglês

10.1136/adc.68.1_spec_no.1

1468-2044

David G. McIntosh, David Isaacs,

Drug-Induced Adverse Reactions

Varicella zoster virus infection in pregnancyPrimary maternal varicella zoster virus infection (chickenpox) during pregnancy can have devastating effects on the mother, the fetus, and the newborn.Maternal shingles, that is reactivation of latent maternal varicella zoster virus infection, can also affect the fetus, albeit less commonly.For varicella zoster virus infections, T cells are of prime importance in recovery from acute infection, while anti- bodies can protect against infection, or at least against severity of infection, but are not primarily involved in recovery.People with impaired cellular immunity, such as those on cytotoxic treatment, tend to get severe and sometimes fatal varicella, whereas children with hypo- gammaglobulinaemia recover normally from chickenpox. Incidence ofvaricella in pregnancyChickenpox is not notifiable, except in Scotland, and even in prospective studies mild cases are probably not reported, while asymptomatic cases may occur.In a large prospective study documented maternal chickenpox occurred in five per 10 000 pregnancies in the United States.'However, adults from tropical or subtropical areas are more likely to be susceptible to varicella.2Kjersem and Jepsen evaluated the incidence of varicella in Tamil refugees in Denmark.3Nine of 44 fertile women were pregnant and two of these acquired varicella infec- tion during the first trimester, none in relation to delivery.Among 118 cases of chickenpox in pregnant North American women, 24 women developed chickenpox pneumonia and 11 of them died.4Thus primary maternal chickenpox appears to be abnormally severe, presumably due to depressed cellular immunity in pregnancy.