Comparison analysis of clinical features of varicella in pregnant women and outcomes of mothers and their newborns

Abstract

Objective To investigate the clinical features of varicella and the prognosis in pregnant women and their newborns. Methods Clinical data of pregnant women with varicella zoster virus (VZV) infection (n=25) and their newborns hospitalized in Beijing Ditan Hospital from 1st Jan. 2008 to 31st Dec. 2014 were retrospectively analyzed and randomly compared to non-pregnant women with VZV infection (n=50). Clinical features and prognosis of varicella in pregnant women and their infants were analyzed. Chi-square test was used for categorical data and t test was used for quantitative data. Results Time to rash scab of varicella in pregnant women was longer than non-pregnant women ([10.1±2.1] d vs [5.6±1.4] d, t=10.941, P<0.05). The rate of bacterial infection in pregnant women was higher than non-pregnant varicella women (72.0%[18/25] vs 32.0%[16/50], χ2=10.761, P<0.05), with statistical significance. Among 25 cases of varicella pregnant women, the pregnancy complications were observed in 3 cases of diabetes, 2 cases of premature rupture of membranes, 5 cases of anemia and 1 case of oligoamnios. Seven cases out of 25 pregnant women underwent parturition during fever and varicella period, and 3 cases (12.0%) were complicated with intrapartum hemorrhage. Twenty five varicella pregnant women were all cured after antiviral and supportive treatment and gave birth to their babies, with no abortion, stillbirth or birth defects. No congenital varicella was observed in newborns. Of the 25 infants, 4 developed (16.0%) varicella within 2 weeks after birth and they were all born from mothers who developed varicella around delivery time. The clinical features of neonatal varicella presented with classic rash with no fever. The time to rash scab was longer (11.0±2.1) d and antibody test for VZV was negative. All neonates were cured after antiviral and immunoglobulin treatment. Conclusions Longer duration of skin rash scab and higher rate of bacterial infections are the features of varicella in pregnant women. Intrapartum hemorrhage occurrs more commonly in pregnant women with varicella onset around delivery time. Varicella occurring during mid-pregnancy may not increase the risk of neonatal birth defects after treatment. The newborns whose mothers with varicella onset during perinatal time especially around delivery time may suffer from varicella. The prognosis of neonatal period varicella is good after treatment. Key words: Chickenpox; Pregnancy; Pregnant women; Infant, newborn; Clinical features; Prognosis