Objective: Intrauterine parvovirus B19-infection can lead to hydrops fetalis. Controlled studies concering the long-term development of surviving children are rare. We compared the morphologic and somatic development of 12 children with connatal B19-infection with a control group of 12 children without infection until the 2nd year of age. Patients and methods: Within the first 2 weeks of life sera of 558 newborns were examined for B19-DNA by PCR and for B19-IgM and -IgG-antibodies by ELISA. Connatal B19-infection was confirmed by a positive B19-PCR in 12 newborns (2.15%). We compared the morphologic (congenital malformations, morbidity during the first two years of life) and somatic development (weight, length, head circumference) of the children with connatal B19-infection (study group) with a control group of 12 children without infection during the first 2 years of age. Children of both groups were examined by an ophthalmologist including fundoscopy. Results: Two patients with connatal B19-infection (16.7%) were born with a heart defect (p > 0.05) but the risk for congenital malformations or ocular disease was not signficantly raised. At the end of the 2nd year of age both groups did not differ significantly concerning their mean weight, length and head circumference. One patient with a brain atrophy developed microcephalus. Conclusions: The somatic and morphologic development of children with a connatal B19-infection does not seem to be disturbed in the long term.

Intrauterine parvovirus B19-infection can lead to hydrops fetalis. In rare cases surviving newborns developed thrombocytopenia or chronic anemia. We compared the hematological values of 12 children with a connatal parvovirus B19-infection (study group) with a group of 12 control patients until the age of 2 years. Virological (PCR), serological (ELISA) and clinical follow-up was done in order to determine the risk of persistent infection, vaccinational complications or immunological disorders. We did not find a higher risk of chronic anemia, thrombocytopenia or leucopenia in children with a connatal B19-infection. One patient with persisting B19-viremia showed normal hematological values. Only one patient with connatal B19-infection seroconverted during the first year of life. Vaccinational complications or clinical signs of chronic immunosuppression were not observed. Conclusions: Chronic hematological abnormalities in children with a connatal B19-infection seem to be rare. Vaccinational complications or immunological disorders are probably not to be expected. B19-IgM-Antibodies at birth and seroconversion during the first year of life are often missing. Therefore postnatal direct viral demonstration is essential for the diagnosis of connatal parvovirus B19 infection.

Click to increase image sizeClick to decrease image sizeKey Words: brain damage of the newbornhyperbilirubinemianewborn's anemiaperinatal parvovirus B19 infectionsprematurity