Herpes Zoster in Pregnancy: Clinical Outcomes and Treatment Patterns from a Multicenter Retrospective Cohort

Hongli Xu,1,* Xiaoyan Qin,2,* Zeguo Feng,3 Shaohua You3 1Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People’s Republic of China; 2Department of Clinical Laboratory, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, 100049, People’s Republic of China; 3Department of Pain Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shaohua You, Department of Pain Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China, Tel +86 13051718025, Email [email protected]: Herpes zoster is a global health issue that can lead to complications like neuropathic pain and is particularly risky for those with weakened immune systems. Pregnant women, who experience natural immunosuppression, may face more severe symptoms or longer recovery. However, there is limited data on how herpes zoster affects pregnant women and their babies, especially in Asian populations.Aim: This multicenter study evaluates herpes zoster outcomes and treatment patterns in Chinese pregnant women.Methods: This retrospective multicenter study analyzed real-world data from the Big Data Center at PLA General Hospital, examining medical records of pregnant women with herpes zoster from January 1, 2010, to June 30, 2024, across four hospitals. We gathered patient demographics, herpes zoster details, and pregnancy and delivery information, followed by descriptive statistical analysis.Results: In this study, 72 pregnant women with herpes zoster were identified, all of whom completed delivery. The average age of the participants was 31.4 ± 4.7 years. Nearly all (98.6%) experienced neuropathic pain. Seven women took oral acyclovir, two used Radix isatidis, and 37 did not receive medication. Ultimately, 38 women had vaginal deliveries, and 34 underwent cesarean sections. No adverse outcomes related to herpes zoster itself or its treatment were observed in either the mothers or their infants.Conclusion: Herpes zoster during pregnancy showed benign maternal-fetal outcomes regardless of antiviral use, supporting cautious management in this population.Keywords: acyclovir, fetuses, herpes zoster, neuropathic pain, pregnancy