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Herpes antibodies in the mother's blood cross the placenta to the fetus.These antibodies help protect the baby from acquiring infection during birth, even if there is some virus in the birth canal.That's the major reason that mothers with recurrent genital herpes rarely transmit herpes to their babies during delivery.Even women who acquire genital herpes during the first two trimesters of pregnancy are usually able to supply sufficient antibody to help protect the fetus.But please think positive thoughts and trust your doctor. While neonatal herpes is rare, women who know they have genital herpes are often concerned about the possibility of transmitting the virus to their babies at birth.
If the mother's infection is a true primary (she has no previous antibodies to either HSV-1 or HSV-2), and she seroconverts (becomes HSV positive) at the end of pregnancy, the risk of transmission can be as high as 50%, according to research by Brown and others.
"The rate of neonatal herpes is very low, even though the prevalence of genital herpes in our country is quite common." Transmission rates are lowest for women who acquire herpes before pregnancy -- one study (Randolph, JAMA, 1993) placing the risk at about 0.04% for such women who have no signs or symptoms of an outbreak at delivery.
The chances of transmission are highest when a woman acquires genital herpes late in pregnancy.
"Babies delivered at term should be protected by antibodies -- but premature babies haven't gotten a full load, "explains Brown.
Mothers who acquire genital herpes during the last trimester of pregnancy may also lack the time to make enough antibodies to send across the placenta.
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"I had several outbreaks during pregnancy and was terrified I would pass the infection to my baby," Maria wrote to the Herpes Resource Center.