Clinical presentation of congenital infection by human Parvovirus B19 in newborns treated at University Hospital of Maternity and Neonatology. 2021-2022

Abstract

Human Parvovirus B19/B19V is among the congenital infection/vertical transmission viruses included in the TORCH group (Toxoplasmosis-Rubella-Chagas-Syphilis-O:others). The characteristics for its suspicion/case definition are not yet well defined, with fetal-neonatal hydrops being the most widely recognized. Its early diagnosis can prevent complications and optimize therapeutic management. Objectives: to identify the presence of congenital B19V infection in newborns/NBs treated at the Maternity and Neonatology University Hospital/HUMN and describe the clinical presentation in positive cases.

A total of 63 newborns with parvoviral/TORCH symptoms and 9 with a history of confirmed maternal B19V infection during pregnancy, attended at HUMN-2021-2022, whose mothers agreed to participate (with signed consent), were included. In cord and/or peripheral blood, viral DNA was determined by molecular biology/PCR and specific IgG and IgM antibodies by ELISA. Maternal clinical data were investigated in positive cases of symptomatic newborns.

The newborns studied for symptoms included suspected/confirmed cases of Syphilis/VDRL 15, Chagas 3, Toxoplasmosis 5; also hydrops 3, hyperbilirubinemia 14, hepatitis/cholestasis 5, polyhydramnios 2, among others (anemia, intrauterine growth retardation, renal failure, myocarditis, coagulation disorders, hepatosplenomegaly). In this group, 4/63 (6.3%) newborns were identified with congenital B19V infection: 1/4 with hydrops and anemia, 1/4 with polyhydramnios and hyperbilirubinemia, 1/4 with maternal B19V+Syphilis/VDRL and 1/4 with B19V. +Maternal Chagas. Among the newborns born to mothers with B19V infection during pregnancy, 1/9 presented vertical infection (with fetal-neonatal hydrops). The most frequent maternal symptom was anemia (8/9).

In conclusion, 4 newborns with parvoviral infection and  clinical signs of the TORCH spectrum were identified during the study period. In addition, vertical transmission was confirmed in 11% of cases with a maternal history of B19V infection during pregnancy. Anemia was the most prevalent maternal history and hydrops, anemia and hyperbilirubinemia, that of NBs, so they could be considered in the design of diagnostic algorithms for B19V among the cases of vertical transmission of the TORCH group.