Genital herpes in pregnancy: what are the risks for the baby?

The genital herpes is a  sexually transmitted disease (STD) responsible for attacking the skin or mucous membranes of the genitals of men and women.

The virus that causes genital herpes ( Herpes simplex ) behaves similarly in pregnant and non-pregnant women. The major problem with herpes in pregnancy is the risk of transmission to the baby. When this happens it is called  neonatal herpes , a condition that can be serious and even lethal for the child.

This transmission, called vertical transmission, occurs during delivery when the baby has contact with contaminated secretions in the vaginal canal or maternal blood. Even when the pregnant woman has no symptoms, the risk of transmission exists.


What are the risks of genital herpes in pregnancy?

The greatest risk occurs when the woman becomes infected near the date of delivery, that is, when the primary infection appears in the last weeks of pregnancy. Rarely, herpes can be transmitted inside the uterus during pregnancy, and it is not an infection that usually causes malformation problems for the fetus.

However, when it comes to a severe case of genital herpes, during the first months of pregnancy there is a risk, even if small, of the woman having a miscarriage.

However, when the baby is infected at the time of delivery, the virus can affect the central nervous system and cause more serious problems to the child’s health, which can result in brain damage, blindness and even death in more severe cases. For this reason, prenatal care is extremely important.

How to avoid transmission to the baby?

When the woman is infected with the virus before pregnancy, the chances of transmission to the baby are reduced, as her body is already able to produce antibodies to the viruses that are temporarily transmitted to the baby when it is inside the mother’s womb. .

So, even if the woman has a genital herpes attack at the time of delivery, the antibodies passed on to her will help her at that time.

Caesarean section greatly reduces the risk of transmission of herpes, being the most suitable form of delivery for infected women, especially in crises. However, it does not eliminate 100% of the baby’s chances of infection.

Therefore, the best way to prevent neonatal herpes is the appropriate treatment of pregnant women (prenatal) , whose use of antiviral drugs should be done. The most used medication is  Acyclovir , which can be administered regardless of the week of pregnancy the woman is in.

Genital herpes is not hereditary and the virus does not affect fertility nor is it transmitted by a man’s sperm or a woman’s egg. Women with genital herpes can have a safe pregnancy and a normal vaginal delivery, except:

  • When it comes to an initial episode of severe genital herpes during the first 3 months of pregnancy, it can cause a miscarriage, which is very rare, but can occur with other types of viral infection;
  • When it is an initial episode in the last 3 months of pregnancy, due to the large number of viruses present and insufficient time for the mother to produce antibodies to protect the fetus, the disease being able to be transmitted to the fetus, causing neonatal herpes.

Pregnant women without a history of genital herpes whose partner has the disease, must use condoms throughout pregnancy to avoid acquiring the disease during this period. Care must be maintained during pregnancy or not.

If the partner has a history of herpes on the face area, oral sex should also be avoided. Genital herpes, in either parent, generally does not affect children and there is little risk of transmission as long as you have normal hygiene habits.

However, parents should be aware that the herpes virus can be transmitted by oral lesions through kissing, which can cause severe and widespread infection in the newborn.

Although neonatal herpes is a very serious condition for the baby, it is also considered rare. According to the  American Sexual Health Association  (ASHA), in the USA, less than 0.01% of babies born are infected with the virus at birth. However, 25% to 35% of pregnant women carry the virus.

This is an important fact to understand that, despite the risk that the baby runs, it is possible to have a healthy and uncomplicated delivery.

If the pregnant woman has herpes, is vaginal delivery safe?

It depends . The risk of transmission is greater when the pregnant woman was infected by the virus during pregnancy, between the first 3 or 3 last months of pregnancy. In such cases, normal birth can be a greater risk for the baby.

That’s because the mother’s body did not have enough time to produce the antibodies needed to protect the baby. However, treatment with antivirals can help to lower the risk, being the first treatment option to make childbirth safe. When this is not possible, cesarean delivery becomes an option.

In any case, the doctor should always be consulted.