CoChat
Sign Up
Cited by 473Herpesvirus Infections and TreatmentsNeonatal and Maternal InfectionsCytomegalovirus and herpesvirus research

Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor.

Open access
Brown, Zane A., Benedetti, Jacqueline, Ashley, Rhoda, Burchett, Sandra, Selke, Stacy, Berry, Sylvia, Vontver, Louis A., Corey, Lawrence·1991·New England Journal of Medicine
DOI 10.1056/nejm199105023241804
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND AND METHODS: To define the risk factors associated with neonatal acquisition of herpes simplex virus (HSV) infection, we prospectively obtained HSV cultures from the cervix and external genitalia of 15,923 pregnant women in early labor who were without symptoms or signs of genital HSV infection. Follow-up of the women with positive cultures for HSV and their HSV-exposed infants included serologic tests and serial cultures for HSV. RESULTS: HSV was isolated from 56 of the women (0.35 percent), 18 of whom (35 percent) had serologic evidence of a recently acquired, subclinical first episode of genital HSV infection, and 34 of whom (65 percent) had reactivation of HSV. Neonatal HSV developed in 6 of 18 infants (33 percent) born to the women with a first episode of genital HSV, and in 1 of 34 infants (3 percent) born to the women with reactivation of HSV (P less than 0.01); neonatal HSV also occurred in three of the infants born to the 15,867 women with negative cultures. Neonatal HSV-2 occurred in 1 of 4 infants born to mothers seronegative at delivery for both HSV-1 and HSV-2, in 4 of 12 infants exposed to HSV-2 whose mothers had only HSV-1 antibodies at delivery, and in none of the infants born to 31 women who were HSV-2-seropositive. An increased risk of neonatal HSV was associated with exposure to viral shedding from the cervix and the use of fetal-scalp electrodes. CONCLUSIONS: Of the asymptomatic women who shed HSV in early labor, about a third have recently acquired genital HSV, and their infants are 10 times more likely to have neonatal HSV than those of women with asymptomatic reactivation of HSV. The presence of maternal antibodies specific to HSV-2 but not HSV-1 appears to reduce the neonatal transmission of HSV-2. Further studies are necessary to determine whether screening and prophylactic treatment are warranted for infants of HSV-2-seronegative mothers who shed HSV-1 or HSV-2 in early labor.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1056/nejm199105023241804

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The risk for transmission to the neonate from an infected mother is low (<1%) among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy.

    “low (<1%) among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy (516,517).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [516]

    The transmission analysis (p. 3) supports a lower risk with recurrent infection than with a first episode at term, but reports 1 of 21 HSV-exposed infants (4.8%) infected when mothers had a history of recurrent symptomatic herpes. The paper does not establish a risk below 1% for all women with a prenatal history of recurrence, and the passages on first episodes address infection near term, not acquisition during the first half of pregnancy. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • The risk for transmission to the neonate from an infected mother is high (30%-50%) among women who acquire genital herpes near the time of delivery.

    “The risk for transmission to the neonate from an infected mother is high (30%–50%) among women who acquire genital herpes near the time of delivery”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [516]

    The Frequency of HSV Transmission section (p. 3) reports neonatal infection in 6 of 18 infants (33%) whose mothers had a recent first episode of genital HSV at term, supporting a high risk within the claimed range. But the study measured women shedding HSV asymptomatically at labor; it does not establish a 30%–50% risk for all women who acquire genital herpes near delivery. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. [5]5. Whitley RJ. Herpes simplex virus infection. In: Remington JF, Klein JO, eds. Infectious diseases of the fetus and newborn infant. 3rd ed. Philadelphia: W.B. Saunders, 1990:282-305.
  2. [9]9. Sullender WM, Yasukawa LL, Schwartz M, et al. Type specific antibodies tes s (- s e ean infants exposed to maternal HSV-2 infection at delivery, and infants with neonatal herpes. J Infect Dis 1988; 157:164-71.
  3. [10]10. Mertz GJ, Ashley R, Burke RL, et al. Double-blind, placebo-controlled trial os s n s vs s isk for genital herpes infection. J Infect Dis 1990; 161:653-60.
  4. [20]20. Keyserling HH, Kerrick CM, Nahmias AJ. Herpes simplex virus infections. In: Remington JR, Klein JO, eds. Infectious diseases of the fetus and newborn infant. 2nd ed. Philadelphia: W.B. Saunders, 1983:636-78.

Cited by

Sorted by citations

Related

Authors
Brown, Z. A., Benedetti, J., Ashley, R., Burchett, S., Selke, S., Berry, S., Vontver, L. A., & Corey, L.
Affiliations
University of Washington (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1991-05-02
Volume
324
Issue
18
Pages
1247-1252
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199105023241804
OpenAlex
W2337806260
Cited by
473
References
25
Citations by year
2026: 6 · 2025: 5 · 2024: 7 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 14 · 2019: 6 · 2018: 6 · 2017: 18 · 2016: 6 · 2015: 7 · 2014: 18 · 2013: 11 · 2012: 16
FWCI
17.32
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ai020381-08)
  • National Institute of Allergy and Infectious Diseases (AI20381)
Topics
  • Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
Keywords
neonatal herpes simplex virus infection, early labor, herpes simplex virus type 1, herpes simplex virus type 2, maternal antibodies, vertical transmission, fetal scalp electrode, risk factors
MeSH terms
Antibodies, Viral, Cervix Uteri, Electrodes, Female, Follow-Up Studies, Herpes Genitalis, Herpes Simplex, Humans, Infant, Newborn, Obstetric Labor Complications, Pregnancy, Prospective Studies, Scalp, Simplexvirus

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review