Abstract

BackgroundChickenpox infection acquired during pregnancy is a serious condition. There may be congenital malformations and neonatal varicella syndrome with significant morbidity and mortality. Egypt has no routine varicella-zoster vaccination program.ObjectiveTo assess the immune status against varicella-zoster virus (VZV) antibodies among a group of pregnant women and to study the relationship between VZV seroprevalence and some sociodemographic characteristics.Subjects and methodsA descriptive cross-sectional study was conducted on a group of pregnant women (n = 333) attending antenatal care (ANC) clinic at Fayoum University Hospital. Serologic testing for VZV was performed using ELISA through the years 2016–2017.ResultsVZV seroprevalence was detected in 294 (88.3%) of the 333 recruited pregnant women. Older age > 25 years old was significantly associated with low percent of VZV-negative antibodies (6.7% in versus 17.4% in younger age, OR (95%CI) 0.34 (0.17–0.70)), also having more than one child was significantly associated with a low percent of VZV-negative antibodies (8.2% versus 16.1% among participants with no children or having one child, OR 0.34 (0.17–0.70)).ConclusionsDespite the absence of a routine VZV vaccination program in Egypt, VZV immunity was high among pregnant women, but less than that reported in many developed countries. We recommend targeted vaccination for women in the reproductive age especially young and primipara.Trial registrationEthical Committee Registration number R67 session 42: date 12/11/2017(retrospectively registered).

Highlights

  • Varicella-zoster virus (VZV) is an alpha-herpes virus neurotropic type

  • Older age > 25 years old was significantly associated with low percent of VZV-negative antibodies (6.7% in versus 17.4% in younger age, OR (95%CI) 0.34 (0.17–0.70)), having more than one child was significantly associated with a low percent of VZV-negative antibodies (8.2% versus 16.1% among participants with no children or having one child, OR 0.34 (0.17–0.70))

  • Despite the absence of a routine VZV vaccination program in Egypt, VZV immunity was high among pregnant women, but less than that reported in many developed countries

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Summary

Introduction

Its primary infection occurs in childhood, causes varicella (chickenpox), and the virus becomes latent in dorsal root ganglia, cranial nerve ganglia, and autonomic ganglia along the entire neuraxis [1]. When VZV cell-mediated immunity decreases with advancing age and immunosuppression, the virus reactivates to produce herpes zoster (shingles), which is complicated. Congenital varicella syndrome (CVS) occurs if pregnant women are infected before 18 weeks of gestation which leads to congenital defects [3]. If pregnant women had VZV infection during the third trimester or close to delivery, this may cause infection in newborn associated with increased mortality rate of infants up to 20%. If contact occurs before and after delivery by days, the risk of chickenpox is about 17–30% if developed in neonates [4, 5].

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