North American Registry of Midwives (NARM) Practice Exam

During which time frame surrounding childbirth is maternal varicella infection most likely to be transmitted to the newborn?

1. Day 3 before birth to Day 1 after birth

2. Day 6 before birth to Day 2 after birth

3. Day 1 before birth to Day 3 after birth

4. Day 2 before birth to Day 4 after birth

The correct answer is: Day 6 before birth to Day 2 after birth

Maternal varicella infection poses significant risks to the newborn, with the potential for transmission occurring primarily in a specific time frame surrounding childbirth. The correct answer identifies the period from six days before birth to two days after birth as the window during which transmission is most likely to occur. Varicella, or chickenpox, is considered a highly contagious viral infection. If a mother experiences varicella during this critical timeframe, the virus can cross the placenta and infect the fetus, leading to congenital varicella syndrome or other neonatal complications. The highest risk of viral transmission to the newborn occurs just before delivery and in the immediate postpartum period because maternal antibodies have not yet formed adequately before childbirth. Knowing this window is crucial for midwives and healthcare providers to implement necessary precautions and monitor the newborn's health. Mothers who are not immune to varicella and contract the illness during this timeframe must be closely watched to mitigate risks to their child. Thus, the timeframe established by the correct answer encapsulates both the timing of maternal infection and the potential vulnerability of the newborn to varicella infection.