What are the potential neonatal outcomes associated with primary HSV-2 infection during pregnancy?

The selection of preterm birth and low birth weight as the correct answer highlights the significant risks associated with a primary HSV-2 infection during pregnancy. When a pregnant person contracts a primary HSV-2 infection, especially in the third trimester, it poses a risk for complications such as preterm labor. The inflammatory response and potential stress on the maternal body during an active infection can lead to early onset of labor.

Furthermore, low birth weight can result from several factors related to the maternal infection and its effects on placental function, fetal growth, and overall maternal health during pregnancy. These can include disruptions in blood flow to the fetus and potential neonatal complications stemming from maternal illness.

In contrast, the other options do not accurately represent the associations typically observed with primary HSV-2 infection in pregnancy. Increased risk of maternal hemorrhage is not a predominant concern linked directly to HSV-2. High Apgar scores generally reflect a well-adjusted neonate at birth, which would likely not occur with the complications associated with HSV-2 infection, and neurodevelopmental outcomes would more likely be negatively impacted rather than improved. Thus, the association of preterm birth and low birth weight with primary HSV-2 infection during pregnancy is well-supported in clinical literature.