Herpes simplex virus (HSV) infections are the most common viral diseases of a man. According to WHO data, the diseases transmitted by herpes simplex virus take the second place (15, %) after influenza (35,8 %) as a cause of death from viral infections [1]. HSV infections present serious threat to reproductive age women as contamination by them during the pregnancy substantially leads to miscarriage, stillbirth, or congenital abnormality of the fetus. The highest prevalence of HSV has cytomegalovirus (CMV) and HSV caused by herpes simplex virus type I and type II [1, 2]. HSV has a leading place among the major causes of neonatal morbidity and mortality. HSV in infants is characterized with polyetiologic, polymorphic clinical symptoms [4]. The character of the course of perinatal and neonatal period substantially determines the future state and quality of life [2, 4].
The aim of the research is to: Study the most significant clinical presentations in term and preterm LBW infants born from mothers with HSV infection in neonatal period and during the first year of life.
Materials and methods. There studied the health of 33 LBW infants born from mothers with HSV infection during pregnancy. Surveyed children were divided into 2 groups. Group 1 included 18 LBW infants born at term 33–36 weeks of gestation. Group 2 included 15 LBW infants born at 37 and above weeks of gestation. Follow-up of infants was being carried out for the first year of life.
Results and their discussion. In assessing the clinical data in preterm infants with low birth weight from mothers who had a history of HSV most often determined by CNS damage, respiratory failure, jaundice and hepatomegaly. In the neurological status the syndrome of motor disturbance was observed in the study group of infants manifested by the decrease in muscle tone (83,3 %), while in term LBW infants the motor disturbances occurred in the form of muscle hypertonus in 75 % cases. The infants in group 1 in contrast to group 2 had seizures in 22,2 % of cases, brain ultrasonography revealed external (38,8 %) and internal (16,6 %) hydrocephalus. When comparing the data of somatic status of infants of both groups it was found that in premature infants with low birth weight, as opposed to infants born at term, there was hepatomegaly (22 %) and conjunctivitis (16,6 %). When comparing the frequency of jaundice in these groups, no significant differences were noted.
The follow-up of this category of infants found that a high incidence of viral respiratory infections during the first year of life (more than 5 times a year; 55,5 % in group 1 and 46,6 % in group 2) was in both groups . The study of biocenosis as an indicator of immunological resistance of the organism in the study groups of infants showed that in the first year of life in 72,2 % of infants in group 1 and 50 % of infants in group 2 were impaired qualitative and quantitative composition of intestinal microflora. But allergodermia manifestations which can also characterize the state of immune status occurred less frequently (22,2 and 13,3 % respectively).
The estimation of neurological status showed that to 1 year of age the disappearance of clinical symptoms of neurological disorders noted in 61,1 % of infants in group 2, while in infants of group 1 remained muscle tone disturbances in the form of muscular hypo- and hypertension (50 %) and respectively (22,2 %), clinical and instrumental investigations confirmed the signs of hydrocephalus in 16,6 % of infants. Thus, from the above it follows that:
– the probability of birth of low weight infants with different terms of gestation and different degree of severity of clinical manifestations in postnatal period from mothers with different types of HSV infection in pregnancy is high;
– in term and preterm LBW infants, the incidence of respiratory diseases in the first year of life is found in half of studied children regardless of gestational age at birth, and neurological symptoms in LBW infants with low gestational age persists over a long period due to morphological and functional immaturity of the central nervous system.
The work was submitted to International Scientific Conference «Modern problems of clinical medicine», Jamaica, April, 16-26, 2013, came to the editorial office 29.04.2013.