J Korean Soc Matern Child Health.  2020 Jul;24(3):133-143. 10.21896/jksmch.2020.24.3.133.

Prevention and Management of Perinatal Major Infectious Diseases

• Park CY
• Cho H

• KMID: 2506055
• DOI: http://doi.org/10.21896/jksmch.2020.24.3.133

Abstract

Perinatal infection is the leading cause of fetal and neonatal mortality and is directly related to childhood morbidity. Perinatal infections cause abnormal growth, delayed development, and many other clinical pro blems in newborns. In particular, TORCH syndrome can cause serious fetal and neonatal health problems through vertical infection, and timely diagnosis and treatment through regular antenatal examinations are important. There are no therapeutic options or vaccines for parvovirus or cytomegalovirus. Therefore, prevention is the most important method. In the case of toxoplasmosis, prenatal education is important because it can be prevented through hygiene management, although there are therapeutic drugs. Syphilis has a high preva­lence, so early diagnosis is important. Rubella and varicella zoster infections can lead to fatal results in vertical transmission to the fetus. Therefore, preconception vaccination should be performed.Women with herpes simplex, which has a high prevalence in the community, need to be mindful when choosing a childbirth method by evaluating the infection through regular prenatal care to prevent vertical infection. Seasonal flu is rarely transmitted vertically to the fetus, but the morbidity and mortality risk to the mother is higher than that of the general population. Thus, prevention through vaccination is important.Lastly, coronavirus disease 2019 (COVID-19) infection has yet to be well studied, although the mother's mor­bidity and mortality are similar to those of the general population and there is no evidence of vertical in­fection. Since the findings of the effects on the mother and fetus are limited, transmission should be pre­vented through social distancing and personal hygiene practices.

Keyword

Perinatal infectious disease; TORCH infection; Seasonal flu; Pregnancy; COVID-19

Reference

Altunaiji S., Kukuruzovic R., Curtis N., Massie J. Antibiotics for whooping cough (pertussis). Cochrane Database Syst Rev. 2007. (3):CD004404.

Bernstein DI., Bellamy AR., Hook EW 3rd., Levin MJ., Wald A., Ewell MG, et al. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Clin Infect Dis. 2013. 56:344–51.

Best JM., Icenogle JP., Brown DWG. Rubella. In : Zuckerman AJ, Banatvala JE, Schoub BD, Griffiths PD, Mortimer P, editors. Principles and practices of clinical virology. 6th ed. Chichester (UK): John Wiley & Sons, Ltd;2009. p. 561.

Bosma TJ., Corbett KM., O'Shea S., Banatvala JE., Best JM. PCR for detection of rubella virus RNA in clinical samples. J Clin Microbiol. 1995. 33:1075–9.

Centers for Disease Control and Prevention (CDC). Knowledge and practices of obstetricians and gynecologists regarding cytomegalovirus infection during pregnancy--United States, 2007. MMWR Morb Mortal Wkly Rep. 2008. 57:65–8.

Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnant women--Advisory Committee on Immunization Practices (ACIP), 2012. MMWR Morb Mortal Wkly Rep. 2013. 62:131–5.

Chen H., Guo J., Wang C., Luo F., Yu X., Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020. 395:809–15.

Cherry JD., Tan T., Wirsing von König CH., Forsyth KD., Thisyakorn U., Greenberg D, et al. Clinical definitions of pertussis: Summary of a Global Pertussis Initiative roundtable meeting, February 2011. Clin Infect Dis. 2012. 54:1756–64.

Cunningham FG., Leveno KJ., Bloom SL., Dashe JS., Hoffman BL., Casey BM, et al. Williams obstetrics. 25th ed. New York: McGraw-Hill;2018. p. 1210.

Dashraath P., Wong JLJ., Lim MXK., Lim LM., Li S., Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020. 222:521–31.

De Oliveira Azevedo CT., do Brasil PE., Guida L., Lopes Moreira ME. Performance of polymerase chain reaction analysis of the amniotic fluid of pregnant women for diagnosis of congenital toxoplasmosis: a systematic review and metaanalysis. PLoS One. 2016. 11:e0149938.

Demicheli V., Jefferson T., Al-Ansary LA., Ferroni E., Rivetti A., Di Pietrantonj C. Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2014. (3):CD001269.

Elshafeey F., Magdi R., Hindi N., Elshebiny M., Farrag N., Mahdy S, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet. 2020. 150:47–52.

Enders M., Weidner A., Zoellner I., Searle K., Enders G. Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases. Prenat Diagn. 2004. 24:513–8.

Faure-Bardon V., Magny JF., Parodi M., Couderc S., Garcia P., Maillotte AM, et al. Sequelae of congenital cytomegalovirus following maternal primary infections are limited to those acquired in the first trimester of pregnancy. Clin Infect Dis. 2019. 69:1526–32.

FIGO. Safe motherhood and COVID. 2020 [Internet]. London: FIGO;c2020. [cited 2020 Jun 19]. Available from: https://www.figo.org/safe-motherhood-and-covid-19.

Gaytant MA., Rours GI., Steegers EA., Galama JM., Semmekrot BA. Congenital cytomegalovirus infection after recurrent infection: case reports and review of the literature. Eur J Pediatr. 2003. 162:248–53.

Gu J., Xie Z., Gao Z., Liu J., Korteweg C., Ye J, et al. H5N1 infection of the respiratory tract and beyond: a molecular pathology study. Lancet. 2007. 370:1137–45.

Hollier LM., Harstad TW., Sanchez PJ., Twickler DM., Wendel GD Jr. Fetal syphilis: clinical and laboratory characteristics. Obstet Gynecol. 2001. 97:947–53.

Irving WL., James DK., Stephenson T., Laing P., Jameson C., Oxford JS, et al. Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study. BJOG. 2000. 107:1282–9.

Istas AS., Demmler GJ., Dobbins JG., Stewart JA. Surveillance for congenital cytomegalovirus disease: a report from the National Congenital Cytomegalovirus Disease Registry. Clin Infect Dis. 1995. 20:665–70.

Kimberlin DW., Lin CY., Jacobs RF., Powell DA., Corey L., Gruber WC, et al. Safety and efficacy of high-dose intravenous acyclovir in the management of neonatal herpes simplex virus infections. Pediatrics. 2001. 108:230–8.

Koch WC., Adler SP. Human parvovirus B19 infections in women of childbearing age and within families. Pediatr Infect Dis J. 1989. 8:83–7.

Koren G. Congenital varicella syndrome in the third trimester. Lancet. 2005. 366:1591–2.

Lamont RF., Sobel JD., Carrington D., Mazaki-Tovi S., Kusanovic JP., Vaisbuch E, et al. Varicella-zoster virus (chickenpox) infection in pregnancy. BJOG. 2011. 118:1155–62.

Luteijn JM., Brown MJ., Dolk H. Influenza and congenital anomalies: a systematic review and meta-analysis. Hum Reprod. 2014. 29:809–23.

Madhi SA., Cutland CL., Kuwanda L., Weinberg A., Hugo A., Jones S, et al. Influenza vaccination of pregnant women and protection of their infants. N Engl J Med. 2014. 371:918–31.

Maldonado YA., Read JS; COMMITTEE ON INFECTIOUS DISEASES. Diagnosis, treatment, and prevention of congenital toxoplasmosis in the United States. Pediatrics. 2017. 139:e20163860.

Mandelbrot L., Kieffer F., Sitta R., Laurichesse-Delmas H., Winer N., Mesnard L, et al. TOXOGEST Study Group. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018. 219:386. e1-386.e9.

Marquez L., Levy ML., Munoz FM., Palazzi DL. A report of three cases and review of intrauterine herpes simplex virus infection. Pediatr Infect Dis J. 2011. 30:153–7.

Masseria C., Martin CK., Krishnarajah G., Becker LK., Buikema A., Tan TQ. Incidence and burden of pertussis among infants less than 1 year of age. Pediatr Infect Dis J. 2017. 36:e54–61.

McQuillan G., Kruszon-Moran D., Flagg EW., Paulose-Ram R. Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016. NCHS Data Brief, no 304. Hyattsville, MD: National Center for Health Statistics;2018.

Miller E., Cradock-Watson JE., Pollock TM. Consequences of confirmed maternal rubella at successive stages of pregnancy. Lancet. 1982. 2:781–4.

Montoya JG., Remington JS. Management of Toxoplasma gondii infection during pregnancy. Clin Infect Dis. 2008. 47:554–66.

Neu N., Duchon J., Zachariah P. TORCH infections. Clin Perinatol. 2015. 42:77–103. viii.

Pertel PE., Spear PG. Biology of herpesviruses. In : Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, editors. Sexually transmitted diseases. New York (NY): McGraw-Hill Medical;2008. p. 381–97.

Rac MW., Revell PA., Eppes CS. Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol. 2017. 216:352–63.

Rasmussen SA., Smulian JC., Lednicky JA., Wen TS., Jamieson DJ. Coronavirus disease 2019(COVD-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol. 2020. 222:395–518.

Reef S. Rubella mass campaigns. Curr Top Microbiol Immunol. 2006. 304:221–9.

Rodis JF., Quinn DL., Gary GW Jr., Anderson LJ., Rosengren S., Cartter ML, et al. Management and outcomes of pregnancies complicated by human B19 parvovirus infection: a prospective study. Am J Obstet Gynecol. 1990. 163(4 Pt 1):1168–71.

Romanin V., Acosta AM., Juarez MDV., Briere E., Sanchez SM., Cordoba BL, et al. Maternal vaccination in argentina: tetanus, diphtheria, and acellular pertussis vaccine effectiveness during pregnancy in preventing pertussis in infants <2 months of age. Clin Infect Dis. 2020. 70:380–7.

Stone KM., Reiff-Eldridge R., White AD., Cordero JF., Brown Z., Alexander ER, et al. Pregnancy outcomes following systemic prenatal acyclovir exposure: conclusions from the international acyclovir pregnancy registry, 1984-1999. Birth Defects Res A Clin Mol Teratol. 2004. 70:201–7.

Török TJ., Wang QY., Gary GW Jr., Yang CF., Finch TM., Anderson LJ. Prenatal diagnosis of intrauterine infection with parvovirus B19 by the polymerase chain reaction technique. Clin Infect Dis. 1992. 14:149–55.

Treanor JJ. Influenza (including avian influenza and swine influenza). In : Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 8th ed. Philadelphia (PA): Elsevier Saunders;2015. p. 2000.

Tubiana S., Belchior E., Guillot S., Guiso N., Lévy-Bruhl D; Renacoq Participants. Monitoring the impact of vaccination on pertussis in infants using an active hospital-based pediatric surveillance network: results from 17 years' experience, 1996-2012, France. Pediatr Infect Dis J. 2015. 34:814–20.

Vera CN., Linam WM., Gadde JA., Wolf DS., Walson K., Montoya JG, et al. Congenital toxoplasmosis presenting as eosinophilic encephalomyelitis with spinal cord hemorrhage. Pediatrics. 2020. 145:e20191425.

Watson JC., Hadler SC., Dykewicz CA., Reef S., Phillips L. Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1998. 47(RR-8):1–57.

Wendel GD Jr., Sheffield JS., Hollier LM., Hill JB., Ramsey PS., Sánchez PJ. Treatment of syphilis in pregnancy and prevention of congenital syphilis. Clin Infect Dis. 2002. 35(Suppl 2):S200–9.

Workowski KA; Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015. 64(RR-03):1–137.

Wu Z., McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in china: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020. Feb. 24. [Epub]. https://doi.org/10.1001/jama.2020.2648.