Fetal and neonatal varicella-zoster infections.

Maternal varicella during pregnancy may have a variety of effects on the fetus and newborn infant. Infection early in pregnancy may result in fetal malformations. Zoster early in life appears to be a sequela of maternal infection at any period during pregnancy. Infants may escape disease, may have mild varicella, or fatal illness following maternal varicella just prior to delivery. The outcome appears to be related to the onset of maternal and newborn illness relative to delivery. A variety of management options are available to the physician. Choices will be dictated by weighing the risks of VZV infection in a particular situation with the risks and benefits of other proposed intervention. In many cases, recommendations must be made on the basis of very limited data. It is hoped that additional information will lead to a more rational approach to VZV infection of the fetus and newborn.