Perinatal Infection Health Article

Definition

Perinatal infections are those infections affecting the mother during a pregnancy, and may be transmitted to the fetus during pregnancy, during delivery through the birth canal, or after delivery through the breast milk.

Description

Perinatal infections may be bacterial, fungal, or viral in nature. The degree to which the mother is affected by the infection is not an indication of its impact on the fetus. The mother may have slight or no symptoms, and yet the fetus may be significantly affected by the infection. The woman's sexual partner(s) may also be affected by these infections and should seek medical treatment. The more common perinatal infections significantly affecting the fetus are discussed below.

Chlamydia

When a woman has multiple partners, the use of condoms every time a woman has sexual intercourse can decrease the risk of becoming infected. Limiting the number of sexual partners also decreases the risk of chlamydial infection.

Cytomegalovirus (CMV)

CMV is a common congenital viral infection, belonging to the herpes virus group of infections. Maternal infection usually occurs through sexual intercourse, including kissing, with an infected individual. Maternal infection may be asymptomatic, or the mother may present with mononucleosis-like symptoms, fatigue, lymphadenopathy, or fever. Transmission to the fetus can occur if the mother becomes infected during pregnancy, or if she has a flaring of a pre-exisisting CMV infection. Some immunity is transferred to the fetus if the mother has had a prior CMV infection. Infants infected in utero with CMV may be asymptomatic, or may have a delayed reaction, manifesting as mental retardation or deafness. About 10% of newborns with congenital CMV have evidence of disease at birth. CMV can also be acquired by the newborn through cervical secretions, saliva, urine, or breast milk. It can also be acquired in the newborn nursery by contact with infected individuals. Individuals with a compromised immune system, organ recipients, and those with HIV/AIDS are more likely to suffer severe consequences.

Genital herpes

Cesarean delivery can substantially reduce disease transmission to the neonate. For mothers with genital herpes, delivery following premature rupture of membranes (PROM) should be considered, as the risk of disease transmission increases by six hours after PROM. If maternal HSV is suspected, a fetal scalp monitor should be avoided, as this creates a direct portal of entry for the infection.