Prevention and management of VZV infection during pregnancy and the perinatal period
Caroline Charlier, Olivia Anselem, Marion Caséris, Marie Lachâtre, Asmaa Tazi, Marine Driessen, Didier Pinquier, Chemsa Le Cœur, Aurélie Saunier, Mathilde Bergamelli, Roxane Gibert Vanspranghels, Anaïs Chosidow, Charles Cazanave, Sophie Alain, Karine Faure, André Birgy, François Dubos, Philippe Lesprit, Julie Guinaud, Robert Cohen, Jean‐Winoc Decousser, E. Grimprel, Cyril Huissoud, Julie Blanc, Gilles Kayem, Fanny Vuotto, Christelle Vauloup‐Fellous
Abstract
• As an infection, chickenpox is more severe in pregnant women than in adults; it exposes the unborn child to three risks: congenital varicella syndrome, potentially severe neonatal varicella, and herpes zoster. • In the event of VZV contamination in a non-immunized pregnant woman, first-line prophylaxis consists in administration of anti-VZV immunoglobulins during the ten days following contact, at a dose of 0.5 to 1 ml /kg (IVL). • Maternal chickenpox during the seven days before and after birth can lead to severe neonatal chickenpox; this situation justifies administration in the child of anti-VZV immunoglobulins as soon as possible following birth (10 days maximum). • Occurrence of maternal chickenpox during the 21 days before and after birth can lead to severe neonatal chickenpox in a child born before 28 weeks of amenorrhea or weighing less than 1000 g at birth; this situation justifies administration in the child of anti-VZV immunoglobulins as soon as possible after birth (10 days maximum).