This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by van der Zwet, W. C.
Right arrow Articles by Zaaijer, H. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by van der Zwet, W. C.
Right arrow Articles by Zaaijer, H. L.
Related Collections
Right arrow Infectious Disease & Immunity

PEDIATRICS Vol. 109 No. 1 January 2002, pp. 79-85

Neonatal Antibody Titers Against Varicella-Zoster Virus in Relation to Gestational Age, Birth Weight, and Maternal Titer

Wil C. van der Zwet, MD*, Christina M.J.E. Vandenbroucke-Grauls, MD, PhD*, Ruurd M. van Elburg, MD, PhD{ddagger}, Anneke Cranendonk, RN{ddagger} and Hans L. Zaaijer, MD, PhD*

* Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, the Netherlands.
{ddagger} Department of Neonatology, VU University Medical Center, Amsterdam, the Netherlands.

--> Objective. Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives protective maternal VZV-immunoglobulin G (IgG) mainly in the third trimester of pregnancy. Therefore, premature neonates are considered at risk for VZV infection. Administration of varicella-zoster immunoglobulin (VZIG) within 96 hours after exposure effectively prevents severe illness in susceptible patients. The objectives of this study were to define the major determinants of the neonatal VZV-IgG titer and to determine the half-life of transplacentally acquired VZV-IgG. Guidelines provided by the Centers for Disease Control and Prevention for the use of VZIG in (premature) neonates were evaluated.

Methods. VZV-IgG titers were measured in sera of 221 neonates and 43 mothers using a quantitative enzyme-linked immunosorbent assay. In 27 neonates, VZV-IgG titers were followed for up to 14 weeks.

Results. In a linear regression model, the maternal antibody titer was the major determinant of the neonatal titer (ß = 0.89); gestational age was only of minor importance (ß = 0.18). The median half-life of VZV-IgG in neonates was 25.5 days (range: 14.6–76.0 days). In the first weeks of life, major fluctuations of the VZV-IgG titer occurred in >50% of the neonates. The predictive value of Centers for Disease Control and Prevention guidelines for identification of neonates who should receive VZIG in case of exposure to VZV was poor: positive and negative predictive values were 0.80 and 0.43, respectively.

Conclusions. The neonatal VZV-IgG titer is predominantly predicted by the maternal VZV-IgG titer, whereas birth weight and gestational age are much less predictive than previously reported.

Abbreviations: VZV, varicella-zoster virus • IgG, immunoglobulin G • VZIG, varicella-zoster immunoglobulin • NICU, neonatal intensive care unit • CDC, Centers for Disease Control and Prevention • VIDAS, Vitek Immuno Diagnostic Assay System • ECV, extracellular volume • PPV, positive predictive value • NPV, negative predictive value

Received for publication Dec 4, 2000; Accepted Aug 22, 2001.




This article has been cited by other articles:


Home page
 CLIN PEDIATRHome page
A. E. Dent and B. A. Baetz-Greenwalt
Herpes Zoster in an Infant
Clinical Pediatrics, September 1, 2007; 46(7): 646 - 649.
[PDF]

Home page
 PediatricsHome page
V. Bekker, H. Scherpbier, D. Pajkrt, S. Jurriaans, H. Zaaijer, and T. W. Kuijpers
Persistent Humoral Immune Defect in Highly Active Antiretroviral Therapy-Treated Children With HIV-1 Infection: Loss of Specific Antibodies Against Attenuated Vaccine Strains and Natural Viral Infection
Pediatrics, August 1, 2006; 118(2): e315 - e322.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
American Academy of Pediatrics, S. R. Rose, and the Section on Endocrinology and Committee on, American Thyroid Association, R. S. Brown, and the Public Health Committee, and Lawson Wilkins Pediatric Endocrine Society
Update of newborn screening and therapy for congenital hypothyroidism.
Pediatrics, June 1, 2006; 117(6): 2290 - 2303.
[Abstract] [Full Text] [PDF]

Home page
 Arch DermatolHome page
J. G. Kurlan, B. L. Connelly, and A. W. Lucky
Herpes Zoster in the First Year of Life Following Postnatal Exposure to Varicella-zoster Virus: Four Case Reports and a Review of Infantile Herpes Zoster
Arch Dermatol, October 1, 2004; 140(10): 1268 - 1272.
[Abstract] [Full Text] [PDF]