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Cesarean Delivery and Risk of Herpes Simplex Virus Infection—Reply
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In Reply: Drs Rouse and Stringer request additional information about the outcome of neonatal herpes infection in our study. These infants were usually enrolled in ongoing multicenter trials of antiviral therapy for neonatal herpes.1-2 Two of the 18 neonates died; of the 9 for whom we have reliable follow-up data, 4 have severe disability. These outcomes are comparable with those previously reported in literature, with substantial mortality and persistent morbidity among survivors, even if treated in infancy.3 We agree that the incidence of neonatal HSV infection appears higher in our area than in other areas of the country. It is not clear how much of that reflects regional differences in epidemiology and how much is lack of case ascertainment in other parts of the country where HSV-2 infection is equally prevalent.
Dr Cohan questions our finding of the protection from HSV transmission by cesarean delivery. Although we agree that the . . . [Full Text of this Article]
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