Serologic and virologic evidence for frequent intrauterine transmission of human parvovirus B19 with a primary maternal infection during pregnancy.
OBJECTIVE
To define the intrauterine viral transmission rate during primary maternal parvovirus B19 infection and identify factors that may influence this rate.


METHODS
Forty-three pregnant women at two medical centers were identified with a primary B19 infection and followed to delivery. At delivery maternal and infant (umbilical cord) blood was obtained for B19 serologic and virologic PCR testing.


RESULTS
All of the women delivered healthy infants at term and none was hydropic. Overall 22 (51%) of the 43 infants had some evidence of a congenital B19 infection. B19-specific IgM was detected in 11 infants at delivery, B19 IgA was detected in 10 and B19 DNA was detectable by PCR in 11 infants. One infant was negative at birth but became positive for IgM, IgA and PCR at 6 weeks of age. No association was found between the likelihood of intrauterine infection and: maternal age; symptomatic maternal infection; method of delivery; maternal IgG titer at delivery; maternal IgG avidity at delivery; or maternal viremia at delivery. Intrauterine infection was associated with maternal IgM positivity at delivery; this association may have been a result of maternal infection occurring later in gestation.


CONCLUSIONS
Although the incidence of intrauterine hydrops and fetal demise after maternal infection is low, there is a high rate of intrauterine viral infection that occurs throughout gestation and yields newborns who, although infected in utero, are asymptomatic at birth.
Koch
W C
WC
Department of Pediatrics, Medical College of Virginia of Virginia Commonwealth University, Richmond 23298, USA. wkoch@hsc.vcu.edu
Harger
J H
JH
Barnstein
B
B
Adler
S P
SP
D000914:Antibodies, Viral / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D016731:Erythema Infectiosum / Q000151:congenital* / Q000175:diagnosis / Q000635:transmission*; D005260:Female; D005312:Fetal Blood / Q000821:virology*; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016732:Parvovirus B19, Human / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology; D011256:Pregnancy Outcome
D000914:Antibodies, Viral; D004279:DNA, Viral; D007136:Immunoglobulins