Neonatal Antibody Titers Against Varicella-Zoster Virus in Relation to Gestational Age, Birth Weight, and Maternal Titer

Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives protective maternal VZV-immunoglobulin G (IgG) mainly in the third trimester of pregnancy. Therefore, premature neonates are considered at risk for VZV infection. Administration of varicella-zoster immuno...

Full description

Saved in:
Bibliographic Details
Published in:Pediatrics (Evanston) 2002-01, Vol.109 (1), p.79-85
Main Authors: van der Zwet, Wil C, Vandenbroucke-Grauls, Christina M.J.E, van Elburg, Ruurd M, Cranendonk, Anneke, Zaaijer, Hans L
Format: Article
Language:English
Subjects:
Age
Antibodies, Viral - blood
Biological and medical sciences
Birth Order
Birth weight
Diseases of mother, fetus and pregnancy
Gestational Age
Guidelines as Topic
Gynecology. Andrology. Obstetrics
Half-Life
Herpesvirus 3, Human - immunology
Humans
Immunity, Maternally-Acquired - immunology
Immunoglobulin G - blood
Infant
Infant, Newborn
Infant, Premature - immunology
Infants (Premature)
Linear Models
Maternal-fetal exchange
Medical sciences
Neonatal care
Pediatrics
Physiological aspects
Predictive Value of Tests
Pregnancy. Fetus. Placenta
Premature infants
Varicella-zoster virus
Viruses
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives protective maternal VZV-immunoglobulin G (IgG) mainly in the third trimester of pregnancy. Therefore, premature neonates are considered at risk for VZV infection. Administration of varicella-zoster immunoglobulin (VZIG) within 96 hours after exposure effectively prevents severe illness in susceptible patients. The objectives of this study were to define the major determinants of the neonatal VZV-IgG titer and to determine the half-life of transplacentally acquired VZV-IgG. Guidelines provided by the Centers for Disease Control and Prevention for the use of VZIG in (premature) neonates were evaluated. VZV-IgG titers were measured in sera of 221 neonates and 43 mothers using a quantitative enzyme-linked immunosorbent assay. In 27 neonates, VZV-IgG titers were followed for up to 14 weeks. In a linear regression model, the maternal antibody titer was the major determinant of the neonatal titer (beta = 0.89); gestational age was only of minor importance (beta = 0.18). The median half-life of VZV-IgG in neonates was 25.5 days (range: 14.6-76.0 days). In the first weeks of life, major fluctuations of the VZV-IgG titer occurred in >50% of the neonates. The predictive value of Centers for Disease Control and Prevention guidelines for identification of neonates who should receive VZIG in case of exposure to VZV was poor: positive and negative predictive values were 0.80 and 0.43, respectively. The neonatal VZV-IgG titer is predominantly predicted by the maternal VZV-IgG titer, whereas birth weight and gestational age are much less predictive than previously reported.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.109.1.79