title: [Varicella-zoster virus and pregnancy].
abstract: The incidence of varicella is low in pregnant women, and estimated around 1/1000 pregnancies. Vaccination is the cornerstone of prevention, but is contraindicated during pregnancy. Varicella is more severe in pregnant women. The risk of viral pneumonia is not increased, but VZV-associated pneumonia is usually more severe in pregnant women. Infection between 0-20 WG is associated with a 2 % risk of congenital varicella syndrome. Infection between D-5 and D+2 of delivery is associated with high risk of severe neonatal infection. Non-immune pregnant women with significant exposure to VZV require post-exposure prophylaxis with specific anti-VZV immunoglobulins that should be administered ideally within 4 days post-exposure and maximum within 10 days of exposure. Anti-VZV immunoglobulins are available in France in the context of an approved expanded access to an investigational new drug. Pregnant women with varicella should receive within 24 hours antiviral treatment based either on valaciclovir or, in case of severe infection, intravenous aciclovir. Both drugs were shown safe during pregnancy, even during the first trimester. Neonates born from mothers who developed varicella between D-5 and D+2 of delivery should also receive as soon as possible specific anti-VZV immunoglobulins.
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service de maladies infectieuses et tropicales, centre d'infectiologie Necker-Pasteur, institut Imagine, 149, rue de Sèvres, 75015 Paris, France; Institut Pasteur, Unité de biologie des infections, Inserm U1117, centre national de référence Listeria, Centre collaborateur OMS Listeria, 75015 Paris, France. Electronic address: caroline.charlier@nck.aphp.fr.
authors.forename: Caroline
authors.initials: C
authors.lastname: Charlier
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service d'obstétrique, 75015 Paris, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Le Mercier
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service d'obstétrique, 75015 Paris, France.
authors.forename: Laurent J
authors.initials: LJ
authors.lastname: Salomon
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service d'obstétrique, 75015 Paris, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Ville
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service de néonatologie, 75015 Paris, France.
authors.forename: Elsa
authors.initials: E
authors.lastname: Kermorvant-Duchemin
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, laboratoire de microbiologie, 75015 Paris, France; AP-HP, hôpital Necker-Enfants-Malades, unité d'immunologie, hématologie et rhumatologie pédiatriques, 75015 Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Frange
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service de pharmacie, 75015 Paris, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Postaire
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service de maladies infectieuses et tropicales, centre d'infectiologie Necker-Pasteur, institut Imagine, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, service de maladies infectieuses et tropicales, centre d'infectiologie Necker-Pasteur, institut Imagine, 149, rue de Sèvres, 75015 Paris, France; Institut Pasteur, Unité de biologie des infections, Inserm U1117, centre national de référence Listeria, Centre collaborateur OMS Listeria, 75015 Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Lecuit
authors.affiliation: Université Paris Descartes Sorbonne Paris Cité, AP-HP, hôpital Necker-Enfants-Malades, laboratoire de microbiologie, 75015 Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Leruez-Ville
mesh_terms: D000212:Acyclovir / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D002644:Chickenpox / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D019433:Chickenpox Vaccine / Q000008:administration & dosage; D000075202:Contraindications; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D000077483:Valacyclovir; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D019433:Chickenpox Vaccine; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir