Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn

Objective: To determine if viral infection of the placenta was associated w ith long-term neurodevelopmental delays in the newborn. Methods: Placental tissue from seven newborn infants with severe respirator y failure and subsequent neurodevelopmental abnormalities as well as ten no rmal controls and five cases of known placental infection (cytomegalovirus, herpes simplex virus, and parvovirus) were tested by in situ hybridization or reverse transcriptase in situ polymerase chain reaction (PCR) for adeno virus, coxsackie virus, cytomegalovirus, Epstein Barr virus, herpes simplex virus, influenza A virus, picornavirus, polyoma virus, parvovirus, respira tory syncytial virus, rotavirus, and varicella zoster virus. Results: Coxsackie virus PNA was detected in six of the seven cases, and in none of the ten normal controls or five cases with known viral infection. Viral RNA localized primarily to the Hofbauer cells and trophoblasts of the terminal villi. Immunohistochemical analysis for the coxsackie virus antig en VP1 yielded equivalent results. Conclusions: In utero coxsackie virus of the placenta is associated with th e development of severe respiratory failure and central nervous system sequ elae in the newborn. This underscores the importance of detailed pathologic and viral examination of the placenta in cases of systemic illness in the newborn. (Obstet Gynecol 2001;98: 1019-26. (C) 2001 by the American College of Obstetricians and Gynecologists.).