{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T02:28:11Z","timestamp":1786328891603,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T00:00:00Z","timestamp":1786147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Infection by the varicella\u2013zoster virus (VZV) during pregnancy is uncommon but clinically relevant, since it may compromise both the mother and the fetus. Although varicella is generally benign and self-limited in childhood, the physiological and immunological changes in pregnancy predispose individuals to more severe forms of the disease, with pneumonia representing the main maternal complication and a leading cause of morbidity and mortality. Vertical transmission may result in congenital varicella syndrome, the most severe fetal consequence, whose risk is greatest between the 13th and 20th weeks of gestation, or in severe neonatal varicella when maternal infection occurs in the peripartum period. This article presents a narrative review of the literature. To enhance methodological transparency and reproducibility, key principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were applied to the literature search and study selection process. Searches were conducted in the PubMed\/MEDLINE and SciELO databases, and 32 studies were included in the narrative synthesis. The review addresses the virology, pathophysiology, and epidemiology of VZV infection, including differences between temperate and tropical regions, as well as its clinical manifestations and maternal, fetal, and neonatal complications. Diagnosis is predominantly clinical, with the polymerase chain reaction being the most sensitive and specific confirmatory method and serology being useful mainly for the assessment of maternal immunity. Management encompasses the assessment of susceptibility, post-exposure prophylaxis according to current guideline recommendations, and early antiviral treatment of established infection. Preconception and postpartum vaccination remain the main preventive strategies. Despite recent advances, important gaps persist regarding prophylactic strategies and the long-term safety of antivirals during pregnancy.<\/jats:p>","DOI":"10.3390\/microorganisms14081745","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T01:20:03Z","timestamp":1786324803000},"page":"1745","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Varicella\u2013Zoster Virus Infection in Pregnancy: Maternal, Fetal, and Neonatal Implications in the Vaccination Era"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9001-259X","authenticated-orcid":false,"given":"Isadora Rodrigues","family":"Almeida","sequence":"first","affiliation":[{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul 09521-160, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Silva","family":"Belo","sequence":"additional","affiliation":[{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul 09521-160, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1257-5752","authenticated-orcid":false,"given":"Tammy Caram","family":"Sabatine","sequence":"additional","affiliation":[{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul 09521-160, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thamy Cristina","family":"Campos","sequence":"additional","affiliation":[{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul 09521-160, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Stefanelli","sequence":"additional","affiliation":[{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul 09521-160, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liris Naomi","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Discipline of Gynecology and Obstetrics, Santo Amaro University (UNISA), S\u00e3o Paulo 04829-300, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana Augustinelli","family":"Sales","sequence":"additional","affiliation":[{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul 09521-160, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6694-6569","authenticated-orcid":false,"given":"Gustavo Yano","family":"Callado","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Albert Einstein Israelite College of Health Sciences (FICSAE), Albert Einstein Israelite Hospital, S\u00e3o Paulo 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9lica Lemos Debs","family":"Diniz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Federal University of Uberl\u00e2ndia (UFU), Uberl\u00e2ndia 38405-320, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0318-9390","authenticated-orcid":false,"given":"Roberta","family":"Granese","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Dental Sciences and Morphofunctional Imaging, \u201cG. Martino\u201d University Hospital, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Araujo J\u00fanior","sequence":"additional","affiliation":[{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul 09521-160, SP, Brazil"},{"name":"Department of Obstetrics, Paulista School of Medicine, Federal University of S\u00e3o Paulo (EPM-UNIFESP), S\u00e3o Paulo 04023-062, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2942-6182","authenticated-orcid":false,"given":"Antonio","family":"Braga","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 22240-003, RJ, Brazil"},{"name":"Department of General and Specialized Surgery, School of Medicine and Surgery, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro 22290-240, RJ, Brazil"},{"name":"Postgraduate Program in Applied Health Sciences, University of Vassouras (Univassouras), Vassouras 27700-000, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bertelli, A., Carta, V., Mangeri, L., Caruso, A., and De Francesco, M.A. (2023). 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Perinatol."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/8\/1745\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T01:33:44Z","timestamp":1786325624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/8\/1745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,8]]},"references-count":31,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["microorganisms14081745"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms14081745","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,8]]}}}