title: Parvovirus B19 infection in pregnancy studied by maternal viral load and immune responses.
abstract: OBJECTIVE
  Facilitate risk assessment of vital complications in fetuses of pregnancies affected by acute parvovirus B19 (B19V) infection.
  
  
  METHODS
  Study of the natural course of maternal B19V infection in four cases, from early pregnancy on.
  
  
  METHODS
  University Medical Center in the Netherlands.
  
  
  METHODS
  Pregnant mothers attending obstetric services.
  
  
  METHODS
  Serial measurements of the maternal and fetal or neonatal viral load and antibody responses.
  
  
  METHODS
  Maternal and fetal/neonatal serum B19V viral DNA load and specific IgM and IgG antibodies in maternal serum.
  
  
  RESULTS
  Peak viral load levels occurred within 1 week after maternal infection and peak IgM levels were observed 1 week after the peak viral load levels. Approximation of IgG and IgM ratios usually took place 4 weeks after infection. Vertical transmission occurred 1-3 weeks after maternal infection, suggesting that fetal infection occurs during the maternal peak viral load.
  
  
  CONCLUSIONS
  Maternal B19V DNA load levels and IgM responses are useful to estimate the risk of parvovirus B19-associated fetal complications. The maternal peak viral load directly precedes the onset of fetal infection and may be used to indicate the stage of intrauterine B19V infection.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Timo R
authors.initials: TR
authors.lastname: de Haan
authors.forename: Matthias F C
authors.initials: MF
authors.lastname: Beersma
authors.forename: Eric C J
authors.initials: EC
authors.lastname: Claas
authors.forename: Dick
authors.initials: D
authors.lastname: Oepkes
authors.forename: Aloys C M
authors.initials: AC
authors.lastname: Kroes
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000276:immunology / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D018445:Infectious Disease Transmission, Vertical; D010322:Parvoviridae Infections / Q000276:immunology* / Q000635:transmission / Q000821:virology; D016732:Parvovirus B19, Human / Q000276:immunology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology* / Q000821:virology; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M