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665471 
Journal Article 
Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn 
Euscher, ED; Davis, J; Holzman, I; Nuovo, GJ 
2002 
1 
Modern Pathology
ISSN: 0893-3952
EISSN: 1530-0285 
DART/TER/2001180 
15 
1 
272A 
English 
Background: The purpose of this study was to determine if viral infection of the placenta was associated with long-term neurodevelopmental delays in the newborn. Design: Placental tissue from seven newborn infants with severe respiratory failure of which six had subsequent neurodevelopmental abnormalities and one unexplained intrauterine fetal demise as well as ten normal controls and five cases of known placental infection (cytomegalovirus, herpes simplex virus, and parvovirus) were tested by in situ hybridization or reverse transcriptase in situ PCR for adenovirus, coxsackie virus, cytomegalovirus, Epstein Barr virus, herpes simplex virus, influenza A virus, picornavirus, polyoma virus, parvovirus, respiratory syncytial virus, rotavirus and varicella zoster virus. Results: Integrity of the tissue RNA was documented by a RNA in situ control. Coxsackie virus RNA was detected in six of the seven placentas and in the fetal CNS from the case of intrauterine demise. The signal was eliminated by prior RNase digestion. Viral titres were available in the mother in only one case, and documented coxsackie viral infection. None of the ten normal controls or five cases with known viral infection had detectable coxsackie virus RNA. Viral RNA localized primarily to the Hofbauer cells and trophoblasts of the terminal villi. Immunohistochemical analysis for the coxsackie virus antigen VP1 yielded equivalent results. The histologic findings in the coxackie virus infected placentas were non-specific. Conclusion: In utero coxsackie virus of the placenta is associated with the development of severe respiratory failure and central nervous system sequela in the newborn. This underscores the importance of detailed pathologic and viral examination of the placenta in cases of systemic illness in the newborn. The non-specific histologic findings emphasize the need for molecular analyses in cases of fetal morbidity and mortality. 
Pregnancy; Infant; Newborn; Human; Female; Placenta VIROLOGY; Coxsackievirus Infections PHYSIOPATHOLOGY; Coxsackieviruses GENETICS; RNA; Viral ISOLATION & PURIF; Pregnancy Complications; Infectious PHYSIOPATHOLOGY; No cas rn