Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases.

Prenat Diagn. 2004 Jul;24(7):513-8.  
  
Fetal morbidity and mortality after acute human parvovirus B19 infection in 
pregnancy: prospective evaluation of 1018 cases.

Enders M, Weidner A, Zoellner I, Searle K, Enders G.

Labor Enders und Partner, Institut fur Virologie, Infektiologie und 
Epidemiologie e.V., Stuttgart, Germany. menders@labor-enders.de

OBJECTIVE: To determine more precisely the incidence of fetal complications 
following maternal parvovirus B19 infection at various gestational ages.

METHODS: An observational prospective study of 1018 pregnant women whose acute 
B19 infection was serologically confirmed in our laboratory.

RESULTS: The observed rate of fetal death throughout pregnancy was 6.3% (64/1018)
(95% confidence interval [CI]: 4.9, 8.0). The fetal death rate for those infected
within the first 20 weeks of gestation (WG) was 64/579 (11.0%). Fetal death was 
only observed when maternal B19 infection occurred before the completed 20 WG. 
The observed stillbirth proportion was 0.6% (6/960). Three of six stillbirth 
cases presented with fetal hydrops. The overall risk of hydrops fetalis was 3.9% 
(40/1018) (95% CI: 2.8, 5.3). Three of 17 cases with non-severe hydrops and 13 
of 23 cases with severe hydrops received intrauterine transfusion(s). The 
proportion of fetuses with severe hydrops that survived following fetal 
transfusions was 11/13 (84.6%). All of the non-transfused fetuses with severe 
hydrops died. 

CONCLUSION: Our data demonstrate a relevant B19-associated risk of fetal death, 
which is largely confined to maternal B19 infection in the first 20 WG. Timely 
intrauterine transfusion of fetuses with severe hydrops fetalis reduces the 
risk of fetal death. Parvovirus B19-associated stillbirth without hydropic 
presentation is not a common finding. 

Copyright 2004 John Wiley and Sons, Ltd.

PMID: 15300741 [PubMed - in process]


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