Pregnancy and herpes
Newborn infants can become infected with herpes virus during pregnancy, during labor or delivery, or after birth.
HSV; Congenital herpes; Herpes - congenital; Birth-acquired herpes; Herpes during pregnancy
Newborn infants can become infected with herpes virus:
If the mother has an active outbreak of genital herpes at the time of delivery, the baby is more likely to become infected during birth. Some mothers may not know they have herpes sores inside the vagina.
Some women have had herpes infections in the past, but are not aware of it, and may pass the virus to their baby.
Herpes type 2 (genital herpes) is the most common cause of herpes infection in newborn babies. But herpes type 1 (oral herpes) can also occur.
Herpes may only appear as a skin infection. Small, fluid-filled blisters (vesicles) may appear. These blisters break, crust over, and finally heal. A mild scar may remain.
Herpes infection may also spread throughout the body. This is called disseminated herpes. In this type, the herpes virus can affect many parts of the body.
Newborn infants with herpes that has spread to the brain or other parts of the body are often very sick. Symptoms include:
Herpes that is caught shortly after birth has symptoms similar to those of birth-acquired herpes.
Herpes the baby gets in the uterus can cause:
Exams and Tests
Tests for birth-acquired herpes include:
Additional tests that may be done if the baby is very sick include:
It is important to tell your health care provider at your first prenatal visit if you have a history of genital herpes.
Herpes virus infection in infants is generally treated with antiviral medicine given through a vein (intravenous). The baby may need to be on the medicine for several weeks.
Treatment may also be needed for the effects of herpes infection, such as shock or seizures. Because these babies are very ill, treatment is often done in the hospital intensive care unit.
Infants with systemic herpes or encephalitis often do poorly. This is despite antiviral medicines and early treatment.
In infants with skin disease, the vesicles may keep coming back, even after treatment is finished.
Affected children may have developmental delay and learning disabilities.
When to Contact a Medical Professional
If your baby has any symptoms of birth-acquired herpes, including skin blisters with no other symptoms, have the baby seen by the provider right away.
Safer sexual practices can help prevent the mother from getting genital herpes.
People with cold sores (herpes labialis) should not come in contact with newborn infants. To prevent transmitting the virus, caregivers who have a cold sore should wear a mask and wash their hands carefully before coming in contact with an infant.
Mothers should speak to their providers about the best way to minimize the risk of transmitting herpes to their infant.
Kimberlin DW, Baley J; Committee on infectious diseases; Committee on fetus and newborn. Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Pediatrics. 2013;131(2):e635-e646. PMID: 23359576 www.ncbi.nlm.nih.gov/pubmed/23359576.
Kimberlin DW, Gutierrez KM. Herpes simplex virus infections. In: Wilson CB, Nizet V, Maldonado YA, Remington JS, Klein JO, eds. Remington and Klein's Infectious Diseases of the Fetus and Newborn Infant. 8th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 27.
Review Date: 6/28/2018
Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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