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Long-term outcome of children following maternal human parvovirus B19 infection
J F Rodis1, C Rodner, A A Hansen
1Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, USA.
Insights
Maternal parvovirus B19 infection during pregnancy did not appear to increase developmental delays in children. However, larger studies are required to confirm these findings on long-term outcomes for children exposed in utero.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Infectious Diseases
Background:
- Parvovirus B19 infection in pregnancy can have potential risks for fetal development.
- Understanding the long-term neurodevelopmental outcomes is crucial for affected children.
Purpose of the Study:
- To assess the long-term health and developmental outcomes of children exposed to parvovirus B19 in utero.
- To compare outcomes between children with recent maternal parvovirus B19 infection and a control group.
Main Methods:
- A cohort study involving pregnant women with serologic evidence of recent or past parvovirus B19 infection.
- Data collected via questionnaires and phone contact regarding pregnancy, birth, and child development up to a median age of 4 years.
- Statistical analysis included descriptive statistics, chi-squared, and Student's t-tests.
Main Results:
- Among 108 surviving children exposed in utero to parvovirus B19, 7.3% exhibited developmental delays.
- A comparison group of 93 children with past maternal infection showed similar rates of developmental delays (7.5%).
- The study had 30% power to detect a twofold difference in abnormal neurodevelopmental risk.
Conclusions:
- No significant increase in developmental delays was observed in children exposed in utero to parvovirus B19.
- Larger-scale studies are necessary to definitively establish the association between in utero parvovirus B19 exposure and neurodevelopmental outcomes.
Objective:
To determine the long-term outcomes of children exposed in utero to maternal parvovirus B19 infection.
Methods:
All pregnant women with serologic evidence of recent parvovirus B19 infection and a comparison group with serologic evidence of past infection from January 1988 to December 1994 were sent questionnaires or contacted by phone about the health and development of their children. Information requested included: pregnancy complications, date of delivery, birth weight, sex, birth defects, need for special care, significant health problems, and developmental delays. All women had serology done at either the Centers for Disease Control and Prevention or the virology laboratory of the Connecticut Department of Health. The data were analyzed using descriptive statistics, chi2 analysis with Fisher exact test, or Student t test in appropriate cases. P < .05 was considered significant.
Results:
Outcome information was obtained from 113 of 117 immunoglobulin-M positive women. The 113 respondents had 103 term singletons, two sets of twins (of which one neonate died of complications of prematurity), one hydropic stillborn, four spontaneous abortions, and one ectopic pregnancy. The mean gestational age at time of exposure was 15.6 weeks. The median age of the liveborn infants in study and comparison groups was 4 years. Eight of the 108 (7.3%) surviving children, one set of twins (exposed at 27 weeks), and six singletons (exposed at 7, 8, 9, 20, 27, and 35 weeks) had developmental delays in speech, language, information processing, and attention. Outcomes were obtained for 99 of 110 patients with past infection; they had 83 liveborn singletons, five sets of twins, two stillborns, and five spontaneous abortions. Seven of the 93 (7.5%) children had developmental delays, similar to the study group. Post-hoc power analysis revealed that 712 infected patients would be needed to find a twofold difference in the risk of abnormal neurologic development; our study had 30% power to find such a difference.
Conclusion:
There is no apparent increase in the frequency of developmental delays in children with exposure in utero to parvovirus, but larger studies are needed.