During which period is maternal varicella zoster infection most concerning for neonatal varicella?

Maternal varicella zoster infection is most concerning for neonatal varicella during the last weeks or days of pregnancy. When a mother contracts varicella (chickenpox) close to the time of delivery, there is a significant risk of the virus being transmitted to the newborn. This is particularly critical because the newborn does not have an established immune response and can develop severe disease if infected with varicella during this vulnerable period.

Infections earlier in pregnancy can lead to complications, but the transmission risk is notably higher just before and around the time of birth. Newborns who contract varicella can develop a severe form of the disease, which may result in significant morbidity and even mortality. Understanding this timing is crucial for midwives and healthcare providers to ensure appropriate monitoring and management of both the mother and the newborn.

In contrast, maternal varicella infections in the first trimester are less concerning for immediate neonatal infection as the risk of transmission is lower, and the fetus may be affected differently. After birth, the newborn is at risk for developing varicella infection if they have not been vaccinated or exposed to maternal immunity, but the worry for immediate transmission during delivery is significantly reduced. Similarly, breastfeeding does not pose a risk for transmission