Il Dong Kim, et al. The two viruses, HSV1 and HSV2, spread themselves through different means. The former being via salivary and respiratory contact whiles the latter through genital contact. Cases of HSV1 infections are seen worldwide and do not discriminate by age. A human with a primary infection may manifest orolabial herpes, gingivostomatitis, pharyngitis and genital herpes.3 One of the most commonly seen sexually transmitted disease would be an HSV infection of the genital tract. Ac- cording to serologic test results, there is a 2% incidence of HSV1 or HSV2 infections among women during pregnan- cy,4 most of them being asymptomatic, as with non-preg- nant women.1 It has also been observed that while postnatal infections are rare (though possible), neonatal infections are usually acquired in utero; during the intrapartum period via exposure to the virus in the genital tract.5 Long-term neuro- logic sequelae has been noted in about 20% of neonatal herpes survivors.6 However neonatal mortality rates have decreased substantially in the last two decades. More spe- cifically, disseminated disease and central nervous system disease mortality rates fell 30% and 4% each.6 Herpes virus screening of gravidas reduces neonatal her- pes infection rates and the need for antiviral drug treatment at the time of delivery. Thus, we studied the presence of HSV2 infections in gravidas by serological methods, and determined the differences between infected and healthy groups of gravidas. Furthermore, we evaluated the need for herpes virus 2 serologic screening in gravidas. MATERIALS AND METHODS A retrospective analysis including 500 gravidas who under- went HSV2 serologic testing and gave birth at our hospital, was carried out between January 2009 and August 2010. The study group was classified as anti-herpes virus 2 antibody- positive, and the following variables were analyzed: clinical course of pregnancy, pregnancy outcome, obstetric compli- cations, and neonatal outcomes. The clinical course and out- comes of pregnancy were assessed for gestational age at de- livery and incidence of fetal loss. Obstetric complications were assessed according to rates of intrauterine growth re- striction, premature rupture of membranes, preterm deliver- ies, and preterm labor. Routine prenatal tests included tests of rubella, varicella, and hepatitis B (HB) antibody titers, and human immunodeficiency virus (HIV) and venereal disease research laboratory (VDRL) tests. Herpes virus 2 serologic tests were performed between 27 and 29 weeks gestation. Gravidas were educated about genital herpes, and, after informed consent for a herpes vi- rus 2 serologic test was granted, a blood sample was ob- tained. At 38 weeks gestation and at the time of delivery, herpes lesions were confirmed based on genital inspection and answers to questions regarding herpes symptoms. If there were symptoms of vaginosis or abnormal vaginal se- cretions antepartum, sexually transmitted disease (STD) testing was performed. Human papillomavirus (HPV) test- ing was performed early during the pregnancy upon request from the gravida. SPSS software (version 14.0) was used for statistical anal- ysis. The average and standard deviations are shown. A chi- square test and Student’s t-test were used for statistical anal- ysis. The significance level for the p-value was set at 0.05. RESULTS Comparison of maternal demographic data The mean age of the gravidas was 31.6±4.6 years in the HSV2 positive group and 30.4±4.2 years in the healthy con- trol group. There was a significant difference in the ages of the gravidas between the two groups (p<0.05). The mean gestational age of the gravidas was 38.9±1.4 weeks in the HSV2 positive group and 39.2±1.1 weeks in the healthy control group. Among 85 gravidas in the HSV2 positive group, 56 were primiparas and 29 were multiparas; in the control group, 296 gravidas were primiparas and 119 were multiparas. The gender ratio of neonates were 1 : 1 in both the HSV2 positive group (42 males and 43 females) and the healthy control group (205 males and 210 females). The av- erage birth weight of neonates was 3.2±0.4 kg in the HSV2 positive group and 3.2±0.3 kg in the healthy control group. There were no significant differences in gestational age, ra- tio of primiparas to multiparas, gender ratio of neonates, and birth weights of neonates between the two groups (Table 1). Comparison of seropositivity No gravidas were rubella IgM-positive in either group. Sev- enty-eight gravidas (91.8%) in the HSV2 positive group and 369 of 415 gravidas (88.9%) in the health control group were rubella IgG-positive. Seventy-eight gravidas (91.8%) in the HSV2 positive group and 386 gravidas (93.0%) in the healthy control group were positive for anti-varicella anti- body. Six of the 85 gravidas (7.1%) in the HSV2 positive 402 Yonsei Med J http://www.eymj.org Volume 53 Number 2 March 2012