Epidemiology, management and outcome of varicella in pregnancy: a 20-year experience at the Tuscany Reference Centre for Infectious Diseases in Pregnancy

Trotta, Michele; Borchi, Beatrice; Niccolai, Alessandra; Venturini, Elisabetta; Giachè, Susanna; Sterrantino, Gaetana; Colao, Maria Grazia; Rossolini, Gian María; Bartoloni, Alessandro; Zammarchi, Lorenzo

doi:10.1007/s15010-018-1150-4

Cited by 18 publications

(16 citation statements)

References 10 publications

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“…An Italian retrospective study reported that in pregnant women exposed to VZV, 72% of those who did not receive post-exposure prophylaxis developed varicella compared with 42% of those who received VZIG (discontinued 2006) [35]. In the current study, the rate of varicella in pregnant women was much lower, at 7.3%.…”

Section: Discussionmentioning

confidence: 44%

Varicella zoster immune globulin (VARIZIG) administration up to 10 days after varicella exposure in pregnant women, immunocompromised participants, and infants: Varicella outcomes and safety results from a large, open-label, expanded-access program

et al. 2019

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Introduction Despite vaccination, there were more than 100,000 annual cases of varicella in the United States in 2013–2014. Individuals at highest risk of developing severe or complicated varicella include immunocompromised people, preterm infants, and pregnant women. Varicella zoster immune globulin (human) (VARIZIG) is recommended by the CDC for postexposure prophylaxis to prevent or attenuate varicella-zoster virus infection in high-risk individuals. Contemporary information on administration of VARIZIG is limited. Methods This open-label, expanded-access program provided VARIZIG to physician-identified, high-risk participants exposed to varicella. Participants included immunocompromised children/adults, infants (preterm, newborns whose mothers had varicella onset within 5 days before or 2 days after delivery, and those aged <1 year), and pregnant women. VARIZIG (125 IU/10 kg [up to 625 IU]) was administered intramuscularly, ideally within 96 hours, but up to 10 days, postexposure. Incidence of varicella rash and severity (>100 pox, pneumonia, or encephalitis) were assessed up to 42 days after administration. Results The varicella outcome population (n = 507) included 263 immunocompromised participants (32 adults, 231 children), 137 pregnant women, 105 infants, and 2 healthy adults with no history of varicella. Varicella incidence was 4.5% in immunocompromised participants, 7.3% in pregnant women, and 11.5% in infants. The incidence of varicella was similar when comparing VARIZIG administration ≤ 96 hours vs > 96 hours (up to 10 days) postexposure in the entire population (6.2% vs. 9.4%, respectively), and also in each subgroup. Of 34 participants with varicella, 5 developed > 100 pox and 1 developed pneumonia and encephalitis. There were no product-related deaths and only 1 serious adverse event (serum sickness) considered probably related to VARIZIG. Conclusion Postexposure administration of VARIZIG was associated with low rates of varicella in high-risk participants, regardless of when administered within 10 days postexposure. VARIZIG was well-tolerated and safe in high-risk participants.

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Section: Discussionmentioning

confidence: 44%

Varicella zoster immune globulin (VARIZIG) administration up to 10 days after varicella exposure in pregnant women, immunocompromised participants, and infants: Varicella outcomes and safety results from a large, open-label, expanded-access program

et al. 2019

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“…In the 2 available studies of pregnant women who received postexposure prophylaxis with VARIZIG, 3,4 the incidence of varicella was low, especially compared with findings from a 20-year retrospective study of postexposure prophylaxis with varicella zoster immune globulin (VZIG, discontinued in 2006) that reported varicella incidence of 42% vs 72% among those who did not receive postexposure prophylaxis. 5 In each study, there was a similar varicella incidence, regardless of the timing of the administration after VZV exposure. No cases of varicellarelated pneumonia occurred in either study.…”

Section: Discussionmentioning

confidence: 86%

Safety and varicella outcomes after varicella zoster immune globulin administration in pregnancy

Swamy

Dotters‐Katz

2019

American Journal of Obstetrics and Gynecology

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Pregnant women generally experience more complications caused by respiratory viruses, which include pneumonia caused by the varicella-zoster virus (VZV). 1 Varicella zoster immune globulin (human; VARIZIG) is recommended for postexposure prophylaxis after exposure to either varicella zoster or herpes zoster to prevent or attenuate varicella zoster infection in high-risk individuals, which includes pregnant women. 2 Administration of VARIZIG is recommended as soon as possible after exposure (ideally within 96 hours). However, the Centers for Disease Control and Prevention guidelines suggest administration up to 10 days after exposure. 2 Given the limited clinical

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“…Varicella-zoster virus (VZV) is a herpesvirus that is transmitted by respiratory droplets, direct contact with skin lesions, and transplacentally during pregnancy [30]. Infants that are exposed to VZV during the last few weeks of pregnancy may develop neonatal varicella which can be quite severe; congenital varicella syndrome (CVS) develops in infants exposed during the pregnancy, with the risk being highest if the exposure occurs in the first trimester [30]. Infants exposed after 20 weeks' gestation only have about 2% chance of developing CVS [31].…”

Section: Varicella-zostermentioning

confidence: 99%

The Impact of Maternal Infection on the Neonate

Ko¹,

Dehority²,

Maxwell³

2021

Congenital Anomalies in Newborn Infants - Clinical and Etiopathological Perspectives

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Maternal infection is a common occurrence during pregnancy, with a substantial impact on the infant. Some infections result in impaired development in utero and even death of the fetus. Other infections may be insidious in the mother but result in growth impairment and hearing loss in the infant. A growing body of evidence suggests that even infections such as chorioamnionitis, thought to have no longterm impact on the infant, may alter fetal development. This chapter will review congenital infections and their impact on neonatal outcomes, as well as newer findings suggesting that acute infection may result in adverse changes in the infant. We will explore novel mechanisms of pathogenesis and virulence, as well as areas that continue with ongoing research.

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Epidemiology, management and outcome of varicella in pregnancy: a 20-year experience at the Tuscany Reference Centre for Infectious Diseases in Pregnancy

Cited by 18 publications

References 10 publications

Varicella zoster immune globulin (VARIZIG) administration up to 10 days after varicella exposure in pregnant women, immunocompromised participants, and infants: Varicella outcomes and safety results from a large, open-label, expanded-access program

Varicella zoster immune globulin (VARIZIG) administration up to 10 days after varicella exposure in pregnant women, immunocompromised participants, and infants: Varicella outcomes and safety results from a large, open-label, expanded-access program

Safety and varicella outcomes after varicella zoster immune globulin administration in pregnancy

The Impact of Maternal Infection on the Neonate

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