title: Parvovirus B19 infection during pregnancy and risks to the fetus.
abstract: Parvovirus B19 infects 1 to 5% of pregnant women, generally with normal pregnancy outcomes. During epidemics, the rate of infection is higher. Major congenital anomalies among offspring of infected mothers are rare, as the virus does not appear to be a significant teratogen. However, parvovirus B19 infection may cause significant fetal damage, and in rare cases, brain anomalies and neurodevelopmental insults, especially if infection occurs in the first 20 weeks of pregnancy. Parvovirus B19 is also an important cause of fetal loss, especially in the second half of pregnancy when spontaneous fetal loss from other causes is relatively rare. Parvovirus B19 infection may affect many fetal organs and can cause severe anemia, following fetal erythroid progenitor cells infection and apoptosis, especially in fetuses, that have shortened half-life of erythrocytes. Severe anemia may cause high output cardiac failure and nonimmune hydrops fetalis. In addition, parvovirus B19 may directly infect myocardial cells and produce myocarditis that further aggravates the cardiac failure. Intrauterine fetal transfusion is commonly used for the treatment of severe fetal anemia with survival rates of 75 to 90% and significant reduction of fetal morbidity. Only 66 cases were evaluated neurodevelopmentally, of which 10 (16%) had slight or severe neurodevelopmental problems. Because parvovirus B19 infection can cause severe fetal morbidity and mortality, it should be part of the routine work-up of pregnant women who have been exposed to the virus or of pregnancies with suspected fetal hydrops. Assessment for maternal infection during pregnancy is especially important during epidemics, when sero-conversion rates are high. Birth Defects Research 109:311-323, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Laboratory of Teratology, Department of Medical Neurobiology, Hebrew University Hadassah Medical School, Jerusalem, Israel.
authors.forename: Asher
authors.initials: A
authors.lastname: Ornoy
authors.affiliation: Laboratory of Teratology, Department of Medical Neurobiology, Hebrew University Hadassah Medical School, Jerusalem, Israel.|Department of Neonatology, Hadassah University Hospital Mount Scopus, Jerusalem, Israel.
authors.forename: Zivanit
authors.initials: Z
authors.lastname: Ergaz
mesh_terms: D016731:Erythema Infectiosum / Q000503:physiopathology* / Q000821:virology; D005260:Female; D005313:Fetal Death; D005315:Fetal Diseases / Q000382:microbiology; D005333:Fetus / Q000821:virology; D006801:Humans; D010322:Parvoviridae Infections / Q000150:complications; D016732:Parvovirus B19, Human / Q000472:pathogenicity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology / Q000821:virology*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D012306:Risk
keywords: anemia; neurodevelopmental problems; nonimmune fetal hydrops; parvovirus B19; pregnancy