Il Dong Kim, et al. sarean section as opposed to a 7.7% of those delivered vag- inally.22 A comparison of the clinical characteristics of HSV2 positive gravidas compared with the healthy control group revealed that there were no significant differences in the rates of preterm delivery, premature rupture of membranes, preterm labor, intrauterine growth restriction, and cesarean section. In this study, the HSV2 positive group did not have higher hepatitis B, varicella, or rubella antibody titers than the healthy control group. However, the HSV2 positive group had a statistically significantly higher rate of positive sexually transmitted disease than the healthy control group. Thus, we recommend sexually transmitted disease screen- ing in HSV2 positive gravidas to help discover the presence of sexually transmitted disease. A limitation of the current study was that herpes virus in- fections and herpes virus antibodies were not assessed in infants born to HSV2 positive gravidas. Educating gravidas on genital herpes and herpes virus 2 screening might reduce the probability of transmitting her- pes virus 2 infections to neonates. In addition, educating gravidas on herpes virus 2 infections could facilitate sexual- ly transmitted disease screening and appropriate treatment. REFERENCES 1. Arvin A, Whitley R. Herpes simplex virus infections. In: Reming- ton J, Klein J, editors. Infectious diseases of the fetus and newborn infant. 5th ed. Philadelphia: W.B. Saunders; 2001. p.425-46. 2. Kristensson K, Lycke E, Sjöstrand J. Spread of herpes simplex vi- rus in peripheral nerves. Acta Neuropathol 1971;17:44-53. 3. Malm G. Neonatal herpes simplex virus infection. Semin Fetal Neonatal Med 2009;14:204-8. 4. Brown ZA, Selke S, Zeh J, Kopelman J, Maslow A, Ashley RL, et al. The acquisition of herpes simplex virus during pregnancy. N Engl J Med 1997;337:509-15. 5. Whitley RJ, Corey L, Arvin A, Lakeman FD, Sumaya CV, Wright PF, et al. Changing presentation of herpes simplex virus infection in neonates. J Infect Dis 1988;158:109-16. 6. Kimberlin DW, Lin CY, Jacobs RF, Powell DA, Corey L, Gruber WC, et al. Safety and efficacy of high-dose intravenous acyclovir in the management of neonatal herpes simplex virus infections. Pediatrics 2001;108:230-8. 7. Corey L, Adams HG, Brown ZA, Holmes KK. Genital herpes simplex virus infections: clinical manifestations, course, and com- plications. Ann Intern Med 1983;98:958-72. 8. Fleming DT, McQuillan GM, Johnson RE, Nahmias AJ, Aral SO, Lee FK, et al. Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med 1997;337:1105-11. 9. Leone P, Fleming DT, Gilsenan AW, Li L, Justus S. Seropreva- lence of herpes simplex virus-2 in suburban primary care offices in the United States. Sex Transm Dis 2004;31:311-6. 10. Centers for Disease Control and Prevention, Workowski KA, Ber- man SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep 2006;55(RR-11):1-94. 11. Diamond C, Selke S, Ashley R, Benedetti J, Corey L. Clinical course of patients with serologic evidence of recurrent genital her- pes presenting with signs and symptoms of first episode disease. Sex Transm Dis 1999;26:221-5. 12. Sheffield JS, Hill JB, Hollier LM, Laibl VR, Roberts SW, Sanchez PJ, et al. Valacyclovir prophylaxis to prevent recurrent herpes at delivery: a randomized clinical trial. Obstet Gynecol 2006;108: 141-7. 13. Watts DH, Brown ZA, Money D, Selke S, Huang ML, Sacks SL, et al. A double-blind, randomized, placebo-controlled trial of acy- clovir in late pregnancy for the reduction of herpes simplex virus shedding and cesarean delivery. Am J Obstet Gynecol 2003;188: 836-43. 14. Gardella C, Barnes J, Magaret AS, Richards J, Drolette L, Wald A. Prenatal herpes simplex virus serologic screening beliefs and prac- tices among obstetricians. Obstet Gynecol 2007;110:1364-70. 15. Vonau B, Low-Beer N, Barton SE, Smith JR. Antenatal serum screening for genital herpes: a study of knowledge and attitudes of women at a central London hospital. Br J Obstet Gynaecol 1997; 104:347-9. 16. Cleary KL, Paré E, Stamilio D, Macones GA. Type-specific screening for asymptomatic herpes infection in pregnancy: a deci- sion analysis. BJOG 2005;112:731-6. 17. Thung SF, Grobman WA. The cost-effectiveness of routine ante- natal screening for maternal herpes simplex virus-1 and -2 anti- bodies. Am J Obstet Gynecol 2005;192:483-8. 18. Baker D, Brown Z, Hollier LM, Wendel GD Jr, Hulme L, Griffiths DA, et al. Cost-effectiveness of herpes simplex virus type 2 sero- logic testing and antiviral therapy in pregnancy. Am J Obstet Gy- necol 2004;191:2074-84. 19. Barnabas RV, Carabin H, Garnett GP. The potential role of suppres- sive therapy for sex partners in the prevention of neonatal herpes: a health economic analysis. Sex Transm Infect 2002;78:425-9. 20. Rouse DJ, Stringer JS. An appraisal of screening for maternal type-specific herpes simplex virus antibodies to prevent neonatal herpes. Am J Obstet Gynecol 2000;183:400-6. 21. Bryson YJ, Dillon M, Lovett M, Acuna G, Taylor S, Cherry JD, et al. Treatment of first episodes of genital herpes simplex virus in- fection with oral acyclovir. A randomized double-blind controlled trial in normal subjects. N Engl J Med 1983;308:916-21. 22. Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA 2003;289:203-9. 23. Whitley R, Arvin A, Prober C, Burchett S, Corey L, Powell D, et al. A controlled trial comparing vidarabine with acyclovir in neo- natal herpes simplex virus infection. Infectious Diseases Collabor- ative Antiviral Study Group. N Engl J Med 1991;324:444-9. 24. Brown ZA, Benedetti J, Ashley R, Burchett S, Selke S, Berry S, et al. Neonatal herpes simplex virus infection in relation to asymp- tomatic maternal infection at the time of labor. N Engl J Med 1991;324:1247-52. 25. Ratanajamit C, Vinther Skriver M, Jepsen P, Chongsuvivatwong V, Olsen J, Sørensen HT. Adverse pregnancy outcome in women exposed to acyclovir during pregnancy: a population-based obser- vational study. Scand J Infect Dis 2003;35:255-9. 26. Eskild A, Jeansson S, Stray-Pedersen B, Jenum PA. Herpes sim- 406 Yonsei Med J http://www.eymj.org Volume 53 Number 2 March 2012