- The Washington Times - Wednesday, January 8, 2003

Having a Caesarean delivery is likely to prevent a pregnant woman with herpes from passing it to her baby, according to a study reported today in the Journal of the American Medical Association.
Herpes simplex virus (HSV) can be deadly to infants. It also can cause blindness, seizures and mental retardation.
The study found that in 10 cases where mothers transmitted herpes to their babies, nine were delivered vaginally and one was delivered by Caesarean, or surgical, procedure.
Until now, there hasn't been any data on whether Caesarean deliveries reduce herpes transmissions.
"Some obstetrical authorities have discussed abandoning this practice," said Dr. Zane A. Brown, lead researcher of the study.
"Perhaps the most clinically important observation from our study was the finding that Caesarean delivery protects against neonatal transmission of HSV," he said. "Our data indicate that it is a rational intervention and should not be abandoned."
Neonatal herpes is rare in the United States. The American Academy of Pediatrics estimates there may be one case in as few as every 3,000 live births and in as many as 20,000 live births.
These numbers are considered low because tens of millions of people carry the herpes virus, either as HSV-1, the "cold sore" variety, or HSV-2, which causes sores in the genital area.
Both kinds of HSV can be transmitted to a partner during sexual activity. And both kinds can be transmitted to babies at birth, although HSV-1 appears to be the most infectious to them.
Neonatal herpes may be rare, but its consequences are "absolutely devastating," said Dr. Brown, who teaches at the University of Washington School of Medicine in Seattle.
"I don't know that there's a marriage that survives it," he said.
Dr. Brown and five colleagues gathered data from more than 40,000 women who were pregnant between 1982 and 1999 and focused their study on 177 women with antibodies for HSV.
The 177 women were divided into two groups 151 who had long-term HSV infections contracted months or years earlier, and 26 who had recently contracted the virus.
Of the 151 women with long-term HSV infections:
About 140 had genital herpes. None of these women transmitted herpes to their infants, regardless of delivery style.
Eleven had the cold sore-type herpes. Eight women chose vaginal deliveries, and two of them transmitted herpes to their babies. None of the Caesarean births resulted in herpes being transmitted.
Of the 26 women who contracted herpes in the last months of pregnancy:
Twenty-two had genital herpes. Thirteen opted for vaginal deliveries, and four of them transmitted herpes to their babies. Nine women chose Caesarean sections, and one of them transmitted herpes to her baby.
Four had cold-sore herpes. All chose vaginal births. Three transmitted herpes to their babies.

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