OBJECTİVE:

To study the possible association between recurrent orofacial herpes during pregnancy and risk for congenital abnormalities.

MATERIAL-METHOD:

The pregnancy of mothers with recurrent orofacial herpes and without orofacial herpes were compared in the population-based large data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities.

RESULTS:

Of 22,843 cases, 429 (1.9%) were born to mothers with recurrent orofacial herpes. Of 38,151 newborn infants, 574 (1.5%) had mothers with recurrent orofacial herpes during pregnancy (adjusted POR with 95% CI: 1.4, 1.2-1.6). This higher risk for congenital abnormalities was explained by the higher prevalence of recurrent orofacial herpes in the second and/or third gestational month (adjusted POR with 95% CI: 1.6, 1.3 and 2.0) and particularly by some specific congenital abnormalities. Pregnant women with recurrent orofacial herpes in the second and/or third gestational month had a higher risk for isolated limb deficiencies, cardiovascular malformations, cleft lip + palate, and multiple congenital anomalies. However, antifever drug treatments can prevent this higher risk for the above congenital abnormalities except cardiovascular malformations. On the other hand neural-tube defects also showed an association with recurrent orofacial herpes in pregnant women without antifever drug treatment. Periconceptional high dose folic acid supplementation also prevented the higher risk for cleft lip + palate, cardiovascular malformations and neural-tube defects.

CONCLUSIONS:

Recurrent orofacial herpes during pregnancy is associated with a higher risk of congenital abnormalities and it may be the indirect effect of high fever related maternal diseases which preceded and triggered the recurrence of orofacial herpes. However, this risk is preventable with antifever drug treatment and/or periconceptional folic acid supplementation in some congenital abnormalities.

Keywords: Recurrent orofacial herpes, congenital abnormalities, high fever, folic acid