Abnormal Development - Varicella Zoster Virus

Introduction

Varicella Zoster Virus or chickenpox maternal infection can be transmitted to the fetus.

Fetal varicella syndrome (FVS) is caused by transplacental infection by the varicella zoster (chickenpox) virus following maternal infection.

Fetal and Neonatal Risks

Risks are dependent on the infection timing.

• before 20 weeks (GA) - FVS can occur with an incidence of about 1%. The lesions can affect the skin, limbs, central and autonomous nervous systems, eyes, cause calcifications, and growth retardation; mortality is high. Lesions typically follow one or several nerve territories, suggesting that damage results from in utero zoster following primary fetal infection.
• during pregnancy - transmission can occur, but is usually asymptomatic; some infants develop zoster postnatally and a few have FVS.
• around delivery - often leads to disseminated neonatal varicella.

PMID 11297117 eMJA - Management of varicella-zoster virus exposure and infection in pregnancy and the newborn period)