Varicella-Zoster Virus

Abstract

Chickenpox in a pregnant woman is uncommon, but it is a major concern for patients and their families, as well as for clinicians caring for pregnant women. Varicella infection during pregnancy is usually benign, but there can be serious consequences for both mother and child. Notably, fetal varicella syndrome (FVS) can happen when infection occurs before 21 weeks of gestation. It can present with serious neurological anomalies and unusual cicatricial skin lesions. Later in pregnancy, primary neonatal varicella may occur when the mother is infected in the peripartum period, and it can be life-threatening. The complications of varicella during pregnancy are reviewed, with an emphasis on early recognition, accurate timing of infection, and risk to the developing fetus and newborn infant. The impact of varicella vaccine on the epidemiology of these infections is reviewed, as well as indications for varicella-zoster virus (VZV)–specific immune globulin and antiviral therapy with acyclovir.