Varicella zoster virus antibody titers after intravenous zoster immune globulin in neonates, and the safety of this preparation

Varicella and herpes zoster during pregnancy has been associated with birth defects, neonatal varicella, herpes zoster in newborns and infants. The aim of the present study was to determine the consequences for the neonates, whose mothers were closely exposed to varicella zoster virus (VZV) during pregnancy. Fifty six pregnant women with uncertain histories of prior VZV infection, after a close exposure to varicella, were enrolled for examination of specific anti VZV antibodies. CFT and ELISA were performed. Eleven (20%) pregnancies were complicated with varicella and 4 (7%) with herpes zoster. Intrauterine varicella infection was identified on the basis of clinical evidences (anomalies characteristic for the congenital varicella syndrome, acute varicella at birth or herpes zoster in infancy) by history of delivery. Four infants with neonatal varicella and their mothers were examined serologically. After a close exposure to varicella, seronegative by CFT were 19 (34%) pregnant women and 9 (16%) by ELISA. Birth defects or herpes zoster in infancy were not found. None of the 4 infants whose mothers had herpes zoster were with physical anomalies. One infant whose mother was with first trimester varicella showed intrauterine retardation. Three babies with neonatal varicella were born by mothers with third trimester varicella and low levels of antibodies to VZV. One infant whose mother lacked antibody to VZV died of neonatal varicella. Varicella during pregnancy was associated with fetal or neonatal infections and diseases, but herpes zoster wasn't.

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