maternal infections during early pregnancy are associated with various
malformations and disorders that are found in their babies. The
most common and best understood infections are represented by the
O-other (gonorrhea, syphilis, varicella, HBV, and HIV)
H-herpes simplex virus
Fetal infection occurs in 0.07% to 0.11% of all pregnancies. It is responsible for serious illness and death in newborns. 10% to 15% die, 85% have severe psychomotor problems or mental retardation at 2 to 4 years, and 50% have visual problems by 1 year. This infection is associated with preterm birth, growth restriction, a baby with a small head or fluid in the head, central nervous system problems, jaundice, and fever. Current research is trying to find out if what is called an IgG avidity test will be able to diagnosis mothers with this infection early in pregnancy so that they can start taking the antibiotic spiramycin to decrease the risks of passing the infection to the baby. This could also seriously decrease the cost of medical testing.
If a pregnant woman carries gonorrhea, once her membranes rupture the infection can travel and contaminate the fetus. The organism can invade the mucosal surfaces of the eye, bottom, and throat. Newborns can have severe infections at birth and are more likely to develop meningitis and other infections. Medicine is placed in the newborns eye's immediately following birth to protect them from complications of the infection that could cause them to be blind.
If syphilis during pregnancy is untreated,
40% to 50% of newborns will have the infection at birth. A specific
strain of this infection, the spirochete Treponema pallidum, if untreated
will cause miscarriage or stillbirth in one in four cases. This
infection may stimulate preterm labor, and can cause problems in
Also know as the chicken pox or shingles. When transmission to the fetus does occur in the early part of pregnancy, the effects on the fetus include arm and leg problems, brain problems, eye deformities, and growth problems inside of mom. When maternal infection occurs in the last 3 weeks of pregnancy, 25% of infants born will develop chicken pox. The more severe the illness the rate of death increases. If a woman is exposed who is not immune, she can receive a vaccine within 72 hours in order to decrease the effects on the fetus.
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome
Women infected with HIV can take zidovudine (ZDV) during pregnancy in order to reduce the risk of transmission to their baby. Current research shows that even though this medication can reduce the risk of transmission, most women will not take the medication properly. Education in this situation is extremely important so that women can know the benefits of the medication. HIV can cause problems with failure to thrive, recurrent or persistent upper respiratory infections and ultimately death because there is no cure. For more information click here
The number of cases of rubella, also known as german measles has decreased because of vaccinations. The greatest risk is if the mother contracts the virus during the first trimester. Hearing loss is the most common result. Other defects include: cataracts or glaucoma, cardiac defects, growth problems in the mother, skin conditions, and brain wave problems. Severe infection may result in fetal death. Delayed effects show up as diabetes mellitus, growth hormone deficiency, heart problems, eye problems, and kidney problems.
CMV infection during pregnancy may result in miscarriage, stillbirth, or what is called neonatal cytomegalic inclusion disease (CMID). Which occurs in 1% of all newborns. This infection can cause problems in the newborn such as growth problems in utero, smaller than normal head, rash, jaundice, anemia, mental retardation, and tooth enamel defects. Current research shows that women who get the infection near the time of concept have a higher incidence of transmission to the fetus, but those who may get it prior to the last menstrual period were found to be at low risk for transmission.
Herpes Simplex Virus
Transplacental transmission of HSV can cause chorioamnionitis (swelling of the amniotic membranes) and may be a factor in increased rate of miscarriages, and preterm birth. If a fetus does contract the infection it is characterized by destruction of normally formed organs. It can cause growth restriction, severe psychomotor restriction, a small head, and seizures. They can suffer from eye problems, deformities, and a short life expectancy.
The most common cause of neonatal sepsis and meningitis in the US is group B streptococcus (GBS). Between 15% and 20% of pregnant women have GBS. Risk factors for the development of early onset GBS include low birth weight, preterm birth, rupture of membranes of more than 18 hours, maternal fever, and having many babies. The infant with GBS may rapidly develop septic shock, which carries significant death rate. Mother's with GBS can receive antibiotics that will reduce the risks of transmission during labor. GBS can also have a late onset between 1 week and 3 months. Eighty-five percent of infants with late onset have meningitis and have a mortality rate of up to 23% and 50% of the survivors develop neurological damage. Current research is working on a vaccine for GBS by studying women's antibody level of IgG which is protective against the infection. The need for this vaccine is increasing because GBS is becoming resistant to antibiotics. For more information related to GBS click here
If a mother passes tuberculosis (TB) to the fetus it can cause ear infections, pneumonia, kidney problems, and enlarged lymph glands. When maternal treatment is initiated early in pregnancy, however, neonatal illness and death rates are similar to those in pregnancies unaffected by TB.
Prenatal infection causes chorioamnionitis or endometritis and should be suspected in cases of meconium-stained amniotic fluid (when the baby passes its first stool while still inside the mother) in infants less than 37 weeks of gestation. It can also cause miscarriage and stillbirth.