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Parvovirus B19 infection and its significance in pregnancy
1Centre for Infectious Diseases and Microbiology, Westmead Hospital, New South Wales. lyng@icpmr.wsahs.nsw.gov.au
Insights
Parvovirus B19 outbreaks, common in children, pose risks to pregnant women, potentially causing fetal anemia and loss. However, the overall risk from occupational exposure during pregnancy remains low.
Area of Science:
- Virology
- Epidemiology
- Obstetrics
Background:
- Parvovirus B19 is a significant cause of erythema infectiosum outbreaks, especially in school-aged children.
- Susceptibility in women of childbearing age is high, with seroconversion rates increasing during epidemics.
- Infection poses risks for anemia in fetuses and can lead to fetal loss and hydrops fetalis in pregnant women.
Purpose of the Study:
- To assess the risks associated with Parvovirus B19 infection in pregnant women, particularly concerning occupational exposure.
- To evaluate the incidence of fetal loss and hydrops fetalis following maternal infection during pregnancy.
- To provide evidence-based recommendations regarding pregnant women's work in environments with potential Parvovirus B19 exposure.
Main Methods:
- Review of epidemiological data on Parvovirus B19 transmission and seroconversion rates.
- Analysis of pregnancy outcomes following maternal Parvovirus B19 infection.
- Calculation of excess fetal loss and hydrops fetalis risks from occupational exposure.
Main Results:
- Maternal infection in early pregnancy is linked to a 10% excess fetal loss rate and 3% incidence of hydrops fetalis.
- Occupational exposure carries a lower risk compared to home exposure.
- The overall risk of serious adverse outcomes from occupational exposure during pregnancy is low, with specific rates for early fetal loss and hydrops fetalis.
Conclusions:
- Parvovirus B19 infection during pregnancy does not cause congenital abnormalities or long-term sequelae.
- The overall risk of adverse outcomes from occupational exposure to Parvovirus B19 for pregnant women is low.
- Routine exclusion of susceptible pregnant women from working with children during epidemics is not recommended.
Abstract:
Parvovirus B19 causes prolonged epidemics of erythema infectiosum, particularly in primary school-aged children. Infection causes clinically significant anaemia in individuals with high red cell turnover, including the fetus. Approximately 40% of women of childbearing age are susceptible, and annual seroconversion rates vary from 1.5% during endemic periods to 10-15% during epidemics. Infection occurs in around 50% of susceptible women exposed at home and 20-30% following occupational exposure (for example, at a primary school). Maternal infection in the first half of pregnancy is associated with 10% excess fetal loss and hydrops fetalis in 3% of cases (of which up to 60% resolve spontaneously or with appropriate management). No congenital abnormalities or long-term sequelae have been attributed to parvovirus B19 infection. The overall risk of serious adverse outcome from occupational exposure to parvovirus B19 infection during pregnancy is low (excess early fetal loss in 2-6/1,000 pregnancies and fetal death from hydrops in 2-5/10,000 pregnancies). It is not recommended that susceptible pregnant women be excluded routinely from working with children during epidemics.