The incidence of, and factors leading to, parvovirus B19-related hydrops fetalis following maternal infection; report of 10 cases and meta-analysis

Yageashi, N.; Niinuma, Takenari; Chisaka, Hiroshi; Watanabe, Takanori; Uehara, Shigeki; Okamura, Koji; Moffatt, Stanley; Sugamura, Kazuo; Yajima, Akira

doi:10.1016/s0163-4453(98)90346-2

Cited by 110 publications

(84 citation statements)

References 76 publications

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“…Aplastic crisis is the direct result of erythroid lineage progenitor cells being infected with B19 and undergoing apoptosis in response to the viral protein, NS1 (Yaegashi et al 1989;Moffatt et al 1998;Chisaka et al 2002). Fetuses infected during the hepatic stage of hematopoiesis are particularly susceptible because of the short half life of their red blood cells (Levy et al 1997;Yaegashi et al 1998). Infectious parvovirus B19 particles were produced in erythroid progenitor cells of the hepatic stage, called productive infection, which may also contribute to the severity of hyporegenerative anemia of the fetus (Yaegashi 2000).…”

confidence: 99%

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Chisaka

Itō

Niikura

et al. 2006

Tohoku J. Exp. Med.

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Parvovirus B19 is a small DNA virus. Infection with parvovirus B19 during pregnancy may cause serious complications in the fetus, including hydrops fetalis and fetal death. The purpose of the present study is to clarify the clinical manifestations and outcomes of parvovirus B19 infection during pregnancy. This prospective study enrolled 478 women with suspected B19 infections during pregnancy between 1999 and 2004. One hundred cases (21%) of B19 infection were detected in 478 pregnant women who had been exposed to B19. Serological infection was confirmed by measurement of B19-specific IgM and IgG in sera. Forty-nine cases reported maternal clinical symptoms and 51 cases were asymptomatic. Facial rash was the most common symptom, with 51% (25/49) of the symptomatic patients complaining of either a facial, body or limb rash. The most common infectious source was children living in the home. Overall, the incidence of adverse fetal effects (including hydrops fetalis and fetal death) related to intrauterine B19 infection was 7% (7/100), and all seven cases were exposed to B19 infection before 20 weeks of gestation. Although half of the cases with parvovirus B19 infections during pregnancy were asymptomatic, patients with adverse fetal effects tended to be symptomatic including rash and fever. These clinical data may supply useful information to produce clinical guidelines for managing B19 infection during pregnancy. parvovirus B19; pregnancy; clinical manifestation; hydrops fetalis; fetal outcome

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confidence: 99%

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Chisaka

Itō

Niikura

et al. 2006

Tohoku J. Exp. Med.

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“…Human parvovirus B19 is the only pathogenic member of the Parvoviridae and causes several diseases in humans, such as transient aplastic crises associated with hemolytic anemias, a common childhood exanthem-erythema infectiosum, some cases of nonimmune hydrops fetalis (NIHF), and chronic bone marrow failure occurring in subjects with immunodeficiency, including AIDS patients (2,27). B19 virus is a small singlestranded DNA virus that lacks an envelope and specifically infects erythroid progenitor cells (12)(13)(14).…”

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confidence: 99%

Human Parvovirus B19 Induces Cell Cycle Arrest at G ₂ Phase with Accumulation of Mitotic Cyclins

Morita

Tada

Chisaka

et al. 2001

J Virol

108

134

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confidence: 99%

“…Although B19 is capable of causing congenital infection, numerous clinical studies show clearly that the majority of women who become infected with B19 during pregnancy deliver healthy infants (9,20,27,29,37). The risk of fetal demise appears to be greatest when infection occurs at or before 20 weeks of gestation (23,37). The incidence of fetal loss caused by parvovirus also varies depending upon whether the infection occurs during an endemic (approximately 1.0 to 1.5%) or epidemic (approximately 5 to 15%) (8,13,29,33) period.…”

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confidence: 99%

Placental Cellular Immune Response in Women Infected with Human Parvovirus B19 during Pregnancy

Jordan

Huff

DeLoia

2001

Clin Diagn Lab Immunol

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Human parvovirus B19 can cause congenital infection with variable morbidity and mortality in the fetus and neonate. Although much information exists on the B19-specific antibody response in pregnant women, little information is available describing the cell-mediated immune (CMI) response at the maternal-fetal interface. The focus of this study was to characterize the CMI response within placentas from women who seroconverted to B19 during their pregnancies and compare it to controls. Immunohistochemical techniques were used to identify the various immune cells and the inflammatory cytokine present within placental tissue sections. Group 1 consisted of placentas from 25 women whose pregnancies were complicated by B19 infection; 6 women with good outcome (near-term or term delivery), and 19 with poor outcome (spontaneous abortion, nonimmune hydrops fetalis, or fetal death). Group 2 consisted of placentas from 20 women whose pregnancies were complicated with nonimmune hydrops fetalis of known, noninfectious etiology. Group 3 consisted of placentas from eight women whose pregnancies ended in either term delivery or elective abortion. The results of the study revealed a statistically significant increase in the number of CD3-positive T cells present within placentas from group 1 compared to group 2 or 3 (13.3 versus 2 and 1, respectively) (P < 0.001). In addition, the inflammatory cytokine interleukin 2 was detected in every placenta within group 1 but was absent from all placentas evaluated from groups 2 and 3. Together, these findings demonstrate evidence for an inflammation-mediated cellular immune response within placentas from women whose pregnancies are complicated with B19 infection.The placenta plays an integral barrier role in limiting congenital viral infections (18). However, some viruses, transmitted via the blood, are able to circumvent this barrier. Virus within maternal blood reaches the intervillous space and makes intimate contact with the placental trophoblast layer, which can lead to virus transmission across that protective barrier to the fetal side. Transmission can occur through breaks in the placental barrier, via endocytosis or receptormediated transfer.The P blood group antigen globoside is the main cellular receptor for B19 (3,4). Globoside is present not only on cells of the erythroid lineage but also on the surface of placental syncytiotrophoblast and cytotrophoblast cells (17). The presence of the globoside receptor on trophoblast cells may play a role in transmission of the virus across the placenta.B19 infection of pregnant women can lead to vertical transmission of virus to the fetus with outcomes that include spontaneous abortion, fetal anemia, nonimmune hydrops fetalis, and intrauterine fetal death (6,15,23,26,31,36). Although B19 is capable of causing congenital infection, numerous clinical studies show clearly that the majority of women who become infected with B19 during pregnancy deliver healthy infants (9,20,27,29,37). The risk of fetal demise appears to be greatest when infecti...

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The incidence of, and factors leading to, parvovirus B19-related hydrops fetalis following maternal infection; report of 10 cases and meta-analysis

Cited by 110 publications

References 76 publications

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Human Parvovirus B19 Induces Cell Cycle Arrest at G ₂ Phase with Accumulation of Mitotic Cyclins

Placental Cellular Immune Response in Women Infected with Human Parvovirus B19 during Pregnancy

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The incidence of, and factors leading to, parvovirus B19-related hydrops fetalis following maternal infection; report of 10 cases and meta-analysis

Cited by 110 publications

References 76 publications

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Human Parvovirus B19 Induces Cell Cycle Arrest at G 2 Phase with Accumulation of Mitotic Cyclins

Placental Cellular Immune Response in Women Infected with Human Parvovirus B19 during Pregnancy

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Human Parvovirus B19 Induces Cell Cycle Arrest at G ₂ Phase with Accumulation of Mitotic Cyclins