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| |    Herpes and Pregnancy by Marjorie Greenfield, M.D. reviewed and revised by Marjorie Greenfield, M.D. For women who have genital herpes, one of the most distressing aspects of the disease can be anxiety about how it might affect the health of their baby. It can be particularly stressful for couples in which only one partner is infected, where the consequences of that person's prior sex life may impinge on the pair's relationship and the joy that normally accompanies news of an impending birth. The fact that it's difficult for most people to bring up and talk about the subject of herpes only increases the likelihood of their receiving less than optimal medical care. In addition to discussing the disease with your partner and your healthcare practitioner, you can also find some basic information below regarding the risk that a genital herpes infection can pose in pregnancy and the steps you can take to prevent it from affecting your child. What is the risk to the baby? Several things factor into the level of risk, including if and when an expectant mother has an outbreak of herpes, whether or not it's her first outbreak, and whether the baby is born vaginally or by cesarean. For the woman who became infected with the herpes virus before conceiving, the most important risk factor is the timing of an outbreak during her pregnancy.
This is the standard recommendation for all women experiencing active herpes. However, those who contracted genital herpes prior to pregnancy have already built up protective antibodies against the virus, which cross the placenta and enter the fetus's bloodstream. Because of this, if the baby is born vaginally through an infected area before a cesarean can be performed, she will have some protection from these antibodies. In fact, less than 3 percent of these newborns will become infected with the virus. This situation is much more serious than it is for the woman who already has been infected and so has the protective antibodies in her body. First episodes of genital herpes can be severe, particularly in pregnancy, with infection of the mother's spinal cord and brain, the liver, and lungs, and terrible genital lesions. Some women, however, do not have any symptoms when they contract the disease or only experience fever and headache without the sores. Some reports have linked first-episode herpes infection in the first trimester with certain birth defects. Contracting herpes during the second or third trimester increases the chances of delivering prematurely and of transmitting the infection to the newborn. If a baby is born through an infected birth canal to a mother with a recently acquired infection, the rate of transmission of the virus to the baby is between 30 and 50 percent, and many of these infants will not survive or will have serious disabilities. For more information, read the article "Preventing Herpes Infections in Newborns."
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