Perinatal infection

Encyclopedia of Medicine by Altha Roberts Edgren

Definition

An infection caused by a bacteria or virus that can be passed from a mother to her baby during pregnancy or delivery is called a perinatal infection.

Description

Perinatal infections include bacterial or viral illnesses that can be passed from a mother to her baby either while the baby is still in the uterus, during the delivery process, or shortly after birth. Maternal infection can, in some cases, cause complications at birth. The mother may or may not experience active symptoms of the infection during the pregnancy. The most serious and most common perinatal infections, and the impact of these diseases on the mother and infant, are discussed below in alphabetical order. It is important to note that men can become infected and can transmit many of these infections to other women. The sexual partners of women who have these infections should also seek medical treatment.

Causes & symptoms

Chlamydia

Chlamydia trachomatis is the most common bacterial sexually transmitted disease in the United States, causing more than 4 million infections each year. The majority of women with chlamydial infection experience no obvious symptoms. The infection affects the reproductive tract and causes pelvic inflammatory disease, infertility, and ectopic pregnancy (the fertilized egg implants somewhere other than in the uterus). This infection can cause premature rupture of the membranes and early labor. It can be passed to the infant during delivery and can cause ophthalmia neonatorum (an eye infection) within the first month of life and pneumonia within one to three months of age. Symptoms of chlamydial pneumonia are a repetitive cough and rapid breathing. Wheezing is rare and the infant does not develop a fever.

Cytomegalovirus

Cytomegalovirus (CMV) is a very common virus in the herpes virus family. It is found in saliva, urine and other body fluids and can be spread through sexual contact or other more casual forms of physical contact like kissing. In adults, CMV may cause mild symptoms of swollen lymph glands, fever, and fatigue. Many people who carry the virus experience no symptoms at all. Infants can become infected with CMV while still in the uterus if the mother becomes infected or develops a recurrence of the infection during pregnancy. Most infants exposed to CMV before birth develop normally and do not show any symptoms. As many as 6,000 infants who were exposed to CMV before birth are born with serious complications each year. CMV interferes with normal fetal development and can cause mental retardation, blindness, deafness, or epilepsy in these infants.

Genital herpes

Genital herpes, which is usually caused by Herpes simplex virus type 2 (HSV-2), is a sexually transmitted disease that causes painful sores on the genitals. Women who have their first outbreak of genital herpes during pregnancy are at high risk of miscarriage or delivering a low birth weight baby. The infection can be passed to the infant at the time of delivery if the mother has an active sore. The most serious risk to the infant is the possibility of developing HSV-2 encephalitis, an inflammation of the brain, with symptoms of irritability and poor feeding.

Hepatitis B

Hepatitis B is a contagious virus that causes liver damage and is a leading cause of chronic liver disease and cirrhosis. Approximately 20,000 infants are born each year to mothers who test positive for the hepatitis B virus. These infants are at high risk for developing hepatitis B infection through exposure to their mothers blood during delivery.

Human immunodeficiency virus (HIV)

Human immunodeficiency virus (HIV) is a serious, contagious virus which causes acquired immunodeficiency syndrome (AIDS). About one-fourth of pregnant women with HIV pass the infection on to their newborn infants. An infant with HIV usually develops AIDS and dies before the age of two.

Human papillomavirus

Human papillomavirus (HPV) is a sexually transmitted disease that causes genital warts and can increase the risk of developing some cancers. HPV appears to be transferred from the mother to the infant during the birth process.

Rubella (German measles)

Rubella is a virus that causes German measles, an illness that includes rash, fever, and symptoms of an upper respiratory tract infection. Most people are exposed to rubella during childhood and develop antibodies to the virus so they will never get it again. Rubella infection during early pregnancy can pass through the placenta to the developing infant and cause serious birth defects including heart abnormalities, mental retardation, blindness, and deafness.

Streptococcus

Group B streptococcus (GBS) infection is the most common bacterial cause of infection and death in newborn infants. In women, GBS can cause vaginitis and urinary tract infections. Both infections can cause premature birth and the bacteria can be transferred to the infant in the uterus or during delivery. GBS causes pneumonia, meningitis, and other serious infections in infants.

Syphilis

Syphilis is a sexually transmitted bacterial infection that can be transferred from a mother to an infant through the placenta before birth. Up to 50% of infants born to mothers with syphilis will be premature, stillborn, or will die shortly after birth. Infected infants may have severe birth defects. Those infants who survive infancy may develop symptoms of syphilis up to two years later.

Diagnosis

Chlamydia

Chlamydial bacteria can be diagnosed by taking a cotton swab sample of the cervix and vagina during the third trimester of the pregnancy. Chlamydial cell cultures take three to seven days to grow but many laboratories are not equipped to run the tests necessary to confirm the diagnosis.

Ctyomegalovirus

Past or recent infection with CMV can be identified by antibody tests and CMV can be grown from body fluids.

Genital herpes

The appearance of a genital sore is enough to suspect an outbreak of genital herpes. The sore can be cultured and tested to confirm that HSV-2 is present.

Hepatitis B

A blood test can be used to screen pregnant women for the hepatitis B surface antigen (HBsAg) in prenatal health programs.