Herpes simplex virus and Epstein-Barr virus infections in pregnancy: consequences of neonatal or intrauterine infection

Herpes simplex virus (HSV) type 1/2 and Epstein-Barr virus (EBV) belong to the human herpes viruses and are among the most ubiquitous viruses in the adult population. In spite of the fact that a large proportion of women at childbearing age are seropositive to these viruses, especially to HSV, primary or secondary infections with these viruses may occur during pregnancy. Genital HSV, especially in primary infections, may be dangerous to the neonate if infected during delivery, as it can cause a severe neonatal disease. Intrauterine infection causing abortion or stillbirth as well as skin scars (cutaneous manifestations), ophthalmologic findings (chorioretinitis, microphtalmia), and neurological involvement (causing brain damage) is also possible, but relatively rare. Primary infection with EBV during pregnancy with apparent transplacental transmission is rare and only few cases were reported. They main damage was in the heart, eyes and liver. The actual damage to the developing embryo and fetus from maternal HSV and EBV seems to be very small. It should be mentioned that both HSV and EBV seem to be able to cross the placenta and cause, as described by several investigators, placental infection manifested by deciduitis and villitis. These placental pathological changes may increase fetal damage.