Newborns exposed to chickenpox through maternal infection in the period immediately surrounding delivery face a distinct and serious clinical risk. This protocol addresses the management of chickenpox in neonates in this specific setting.
Neonates have a significant risk of severe varicella infection when the onset of maternal infection is within 5 days prior to or 2 days after delivery, due to the lack of transfer of protective maternal antibodies and the relative immaturity of the neonatal immune system.
This protocol applies when maternal chickenpox develops in the window from 7 days before to 7 days after delivery — a period in which the neonate may not have acquired sufficient passive immunity.
Neonates have a significant risk of severe varicella infection when the onset of maternal infection is within 5 days prior to or 2 days after delivery, due to the lack of transfer of protective maternal antibodies and the relative immaturity of the neonatal immune system.
VZIG is recommended for all infants whose mothers develop chickenpox 7 days before to 7 days after delivery.
Intravenous aciclovir should be given to these infants if they develop chickenpox, whether or not they received VZIG.
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