Perinatal transmission of six common viruses

Abstract

Vertical transmission of viruses is one of the most common causes of perinatal morbidity and mortality worldwide. In 2019 the national physician assistant exam was updated to include the prenatal transmission of several viruses. Considering this update, the focus of this clinical review is to provide evidence-based information to equip physician assistants and other primary care providers with the information to educate patients and recognize potential complications relating to the vertical transmission of the following viruses: varicella zoster virus, HPV, HSV, Zika virus, Hepatitis B, and Hepatitis C. For the purposes of this paper, vertical transmission is defined as maternal infections that are acquired by the infant, either in utero or in the immediate postnatal period. Perinatal transmission is defined as transmission occurring immediately before or after birth. This paper outlines the pathophysiology of transmission regarding each virus, perinatal complications, and what diagnostic tests and treatments may be indicated. Readers will also become familiar with the prenatal and perinatal preventative care associated with these viruses. The responsibility of identification of these viruses falls largely on primary care providers to ensure early intervention and referral to specialty care providers to ensure the best possible outcomes for both mother and neonate. Relevant information was retrieved using electronic databases including CINAHL, MEDLINE, and Cochrane library, as well as CDC.org, USPSTF.org and ACOG.org. A manual search was done using the references of relevant articles and published guidelines.