From the Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Pediatr Infect Dis J. 2018 Aug;37(8):806-813. doi: 10.1097/INF.0000000000001905.
This article provides an update on the incidence of neonatal herpes, guideline adherence by health care professionals (HCP) and trends in genital herpes simplex virus (HSV) infection during pregnancy in the Netherlands.
Questionnaires were sent to all hospitals inquiring about numbers and characteristics of neonatal and maternal HSV infections, and guideline adherence between 2012 and 2015. Longitudinal trends were investigated from 1999 onward using survey data and Perinatal Registry of the Netherlands data (Perined). Trends were smoothed with Poisson regression splines. Risk indicators for neonatal and maternal HSV infections were examined with Poisson regression analyses.
Neonatal herpes incidence was 4.8/100,000 live births based on survey data (2012-2015) and 3.4/100,000 based on Perined (2012-2014). Mortality rate was 23% (7/30). Neonatal herpes incidence increased slightly over time as did the prevalence of genital HSV infection among pregnant women. Non-Western ethnicity (Rate Ratio: 1.9; 95% confidence interval: 1.5-2.5) and age <20 years (Rate Ratio: 2.3; 95% confidence interval: 1.2-4.7) were associated with genital herpes during pregnancy. In Perined, none of the neonatal herpes cases had a mother diagnosed with an active genital herpes infection during pregnancy. Preventive measures to reduce vertical herpes transmission (such as cesarean section) were less commonly reported by HCP in 2012-2015 compared with 2006-2011.
Neonatal herpes incidence in the Netherlands slowly increased over the last 15 years. An increased genital HSV prevalence during pregnancy or, to lower extent, the decreased guideline adherence by HCP may be responsible. A rise in asymptomatic maternal HSV shedding is also plausible, emphasizing the challenges in preventing neonatal herpes.
本文提供了荷兰新生儿疱疹发病率、医护人员（HCP）遵循指南情况以及妊娠期间生殖器单纯疱疹病毒（HSV）感染趋势的最新信息。
向所有医院发送问卷，询问新生儿和产妇 HSV 感染的数量和特征，以及 2012 年至 2015 年期间的指南遵循情况。使用调查数据和荷兰围产期登记处（Perined）数据，从 1999 年开始研究纵向趋势。使用泊松回归样条对趋势进行平滑处理。使用泊松回归分析检查新生儿和产妇 HSV 感染的风险指标。
基于调查数据（2012-2015 年），新生儿疱疹发病率为每 100,000 例活产儿 4.8 例，基于 Perined（2012-2014 年）为 3.4/100,000。死亡率为 23%（7/30）。新生儿疱疹发病率随着时间的推移略有增加，孕妇生殖器 HSV 感染的流行率也有所增加。非西方种族（比率比：1.9；95%置信区间：1.5-2.5）和年龄<20 岁（比率比：2.3；95%置信区间：1.2-4.7）与妊娠期间生殖器疱疹有关。在 Perined 中，新生儿疱疹病例中没有母亲在怀孕期间被诊断为活动性生殖器疱疹感染。与 2006-2011 年相比，2012-2015 年 HCP 报告的减少垂直疱疹传播的预防措施（如剖宫产）较少。
在过去 15 年中，荷兰新生儿疱疹发病率缓慢上升。妊娠期间生殖器 HSV 流行率增加，或者 HCP 遵循指南的情况有所下降，可能是导致这种情况的原因。孕妇无症状 HSV 脱落增加也是合理的，这强调了预防新生儿疱疹的挑战。
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