Neonatal herpes in Denmark 1977-1991

Background. To prevent neonatal herpes, women in labor with genital herpes infection are still delivered by Cesarean section. This policy is currently being debated. The aim of this study was to determine the incidence of neonatal herpes in Denmark and to evaluate the prevention practice. Methods. All newborns with perinatal herpes in Denmark 1977-1991 were identified from hospital-records. Results. Of 862,298 deliveries 136 possible cases were found but only 30 (22%) fulfilled the criteria for neonatal herpes. The incidence increased from 2.36 to 4.56 per 100,000 live births during 1977-1984 through 1984-1991. Three mothers (10%) had recurrent herpes at delivery, three (10%) had primary herpes, and five (17%) had oral herpes. Seven infants (23%) were delivered by Cesarean section. Nine (30%) only had cutaneous herpes, four (13%) had CNS herpes, nine (30%) had disseminated disease. Six (20%) did not have any sequelae. Four (13%) died. Six (20%) had serious neurological sequelae. Seven (23%) only had cutaneous recurrences. In seven cases (23%) information was insufficient. Conclusions. During a 15 year period in Denmark only one neonate had serious sequelae following a recognized maternal herpes recurrence. Four infants had a serious infection in spite of Cesarean section. This study does not support a policy of Cesarean section in case of maternal recurrent herpes simplex infection at delivery.