SERONEGATIVITY TO VARICELLA-ZOSTER VIRUS IN A TERTIARY CARE OBSTETRICPOPULATION

Objective: To determine the seronegativity rate of varicella-zoster vi rus in a tertiary care obstetric population. Methods: At their initial prenatal visit, all obstetric patients at Westchester County Medical Center have a varicella-zoster virus IgG antibody titer (Varicella Sta t; Biowhittaker, Inc., Walkersville, MD) performed. A value of 0.99 or greater units is positive. Patients were divided into three groups: s eronegative, seropositive, and those with no test results. Mean matern al age was compared among groups using the unpaired two-tailed Student t test, with P < .05 considered significant. Results: From February 1 , 1994, to May 30, 1996, 927 women had an initial prenatal visit. Nine ty-nine patients were varicella-zoster virus antibody negative (serone gativity 11.6%, which is significantly higher than that reported in ot her studies); 755 were varicella-zoster virus antibody positive, and 7 3 had no results. The mean age of the seronegative patients was 27 yea rs and of the seropositive patients 28 years, which was not significan tly different. Conclusion: Varicella-zoster virus seronegativity is hi gher in our obstetric population than generally is reported in adults. This may reflect the number of immigrants from tropical countries att ending metropolitan hospitals. Mathematic models evaluating the impact of varicella-zoster virus vaccination and decisions regarding screeni ng and postpartum vaccination must be based on accurate epidemiologic data, particularly in view of the effect of varicella-zoster virus on pregnant women, their fetuses, and their neonates. (C) 1997 by The Ame rican College of Obstetricians and Gynecologists.