Perinatal Survival Following Parvovirus B19 Infection: Overall Outcomes and a Secondary Comparison of the 2023-2024 Outbreak to the Previous Two Decades.

OBJECTIVES

To evaluate perinatal survival following maternal parvovirus B19 virus (B19V) infection and compare the 2023-2024 outbreak to prior decades.

METHOD: A single tertiary center retrospective study (2005-2024) of all pregnancies with confirmed maternal B19V infection. Data on maternal, fetal, and neonatal outcomes were collected, with live birth rate as the primary outcome. Patients were divided into the 2023-2024 outbreak group and a control group (2005-2022) for comparison.

RESULTS

Among 124 patients, 51 comprised the outbreak group and 73 comprised the control group. The live birth rate was 90.3%. Fetal hydrops (OR 18.0, 95% CI 2.12-153.03), intra-uterine transfusion (IUT) requirement (OR 1.33, 95% CI 1.09-1.69) and an earlier gestational age at first IUT (OR 0.6, 95% CI 0.37-0.96) were associated with decreased perinatal survival. The outbreak group presented earlier (15.5 [IQR 10.2-20.4] vs. 19.5 [IQR 15.0-23.0], p = 0.04), and had a higher fetal viral load (cycle threshold value 11.5 [IQR 7.54-13.57] vs. 16.63 [IQR 13.42-20.59], p = 0.01). However, rates of hydrops, indication for IUT, perinatal survival, abnormal CNS findings, and neonatal outcomes did not differ between the groups.

CONCLUSIONS

Fetal hydrops and an earlier indication for IUT were predictors of IUFD. Despite earlier presentation and higher viral load, the outbreak did not worsen perinatal outcomes.