Neonatal Herpes: 
I’m pregnant with herpes,
how will this affect my baby?


Neonatal Herpes (also known as Congenital Herpes) is a rare but serious condition affecting 1 in every 3,200 live births. It is one of the most severe prenatal infections that can be caused by either HSV 1 or HSV 2.

Congenital Herpes can cause a lot of distress, especially to expectant mothers. It’s normal to feel worried. But keep in mind that most babies born to mothers infected with herpes are born healthy. There is only a higher risk of mortality if the mother has, for the first time, acquired the herpes virus late in pregnancy. 

As a mother-to-be, you can play an active role in preventing the transmission of the herpes virus to your baby. Get regular checkups and talk to your caregiver, midwife or doctor. Being honest with them about your medical and sexual history will help in ensuring a safe and healthy delivery. 

In the meantime, here are the essential facts that you need to know, in order to minimize the risk of herpes transmission:

How is Neonatal Herpes transmitted?

Most cases of neonatal herpes are acquired during delivery, when the baby passes through the mother’s birth canal infected with sores of a herpes outbreak. This is most common with mothers who recently obtained a herpes infection during the last trimester of pregnancy, because the body has not yet developed antibodies against the virus.

Vertical transmission of the herpes virus can also happen in utero (i.e. when the baby is still growing inside the womb of the mother). Postnatal herpes infections occur when the baby is unwittingly exposed to sores of an active herpes infection after birth (e.g. via kisses from relatives with oral herpes).

What are the manifestations of Congenital Herpes?

Clinical features of congenital herpes are usually observed during the first month of the baby’s life, when signs and symptoms of a herpes infection start to appear. The infection can appear in three forms:

  1. Skin- small, fluid-filled blisters may appear localized to the initial site of infection. These sores may take days before they heal, dry up, and scab—sometimes leaving scars.
  2. Eyes- also known as ocular herpes, the sores can appear around the eye area that can cause inflammation to the cornea and iris, sometimes resulting in loss of vision.
  3. Mouth- oral herpes can cause painful ulcers on the lips, and along the gums and mucous membranes of the oral cavity.

Disseminated neonatal herpes infection with the onset of non-specific symptoms is also a possibility. It is the most severe form of neonatal herpes that affects multiple organs. This infection can present with jaundice, seizures, and irritability among a few.

neonatal herpes

What are the complications involved in Neonatal Herpes?

Neonatal herpes can cause sepsis, premature labor, miscarriages, and still births. Despite these threats, death from neonatal herpes infection continues to decrease. Thanks to the important breakthroughs in the understanding of how HSV is transmitted to the fetus, and the advanced medical strategies in antiviral herpes treatment, prognosis for the neonate is fairly high.

How do I prevent my baby from acquiring the infection?

For pregnant women with herpes, it is imperative to let your midwife or doctor know about your medical history and condition. That way, they can monitor the first signs and symptoms of a possible risk of transmitting the herpes virus to your baby.

  1. Observe safe sexual practices such as using a condom and abstaining from sex in the advent that you (or your partner) experience herpes outbreaks.
  2. Take oral antiviral suppressive medication if you notice the first sign or symptom of a genital herpes outbreak. Ask your doctor for a prescription.
  3. Avoid contact with individuals, relatives, and friends with the herpes virus. If they have an active cold sore, have them wear surgical masks when they come near you and/or your baby.
  4. Consider a C-section if you acquire the herpes virus during the last three months of pregnancy. Again, talk to your physician so he can provide thorough assessment on the appropriate mode of delivery.
  5. Just relax. Be assured that the risk of transmission from mothers with recurrent infection is low. Getting stressed while pregnant may affect your baby inside.

What is my next step? Will my baby be alright?

You’re likely to be scared and overwhelmed with all the information out there. But acquiring the proper knowledge about the condition can provide you with the basic understanding on how to effectively manage the condition.

  1. Follow preventative protocols such as washing of hands and proper hygiene. This way you can avoid neonatal herpes from happening.
  2. Educate family members who have cold sores. The reason why herpes gets spread around so easily is due to the lack of knowledge about the infection.
  3. Be honest about your condition to your doctor. They can provide appropriate evaluation, counselling, and instruction. Inform them if you experience any suspicious sores or symptoms.
  4. Report any signs of infection such as poor feeding, lethargy, and fever. Be wary of any lesions on your baby’s body. Prompt diagnosis and initiation of treatment are critical to neonatal outcome.
  5. Read the Herpes Survival Guide. It contains information about safe sexual practices and tips on how to live a healthy life with herpes.

By following these few simple steps, you can play an active role early on, in minimizing the risk of herpes transmission to your baby.

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