Birth Injuries From Maternal Infections

For most adults, an infection is not something to be overly concerned about. Infections are a part of everyday life. We get some antibiotics and they usually go away without any long-term health implications. Even if we never go to the doctor and get antibiotics, most infections eventually just go away on their own. For pregnant mothers, however, infections can have potentially serious consequences particularly when they go untreated.

Certain undiagnosed and untreated maternal infections during pregnancy can actually harm the baby and result in serious birth injuries, including the need for resuscitation, brain injuries, and even death. Diagnosis and treatment of maternal infections is a critical component of good prenatal care.

Common Infections That can Result in Birth Injuries

Not all infections are potentially dangerous during pregnancy. There are, however, a host of relatively common infections during pregnancy that can cause devastating harm to developing babies if not promptly diagnosed and treated.

• Group B Strep: Group B streptococcus (GBS) is a very commonly occurring type of bacteria. At any given time an estimated 25% of all adult women U.S. carry GBS bacteria in the rectal, gastrointestinal, or vaginal areas. In pregnant mothers, a prompt diagnosis and treatment of a GBS infection are very important. Untreated GBS infections can be transferred to the fetus during pregnancy. This can be very dangerous for the baby as GBS infection can disrupt normal brain development and cause the baby to be born with serious neurologic damage. The problem with GBS is that it often does trigger any symptoms, making it difficult to diagnose in some cases.
• Rubella: Also known as German Measles, rubella is a virus that once very widespread during childhood. Rubella and measles have for the most part been eradicated in the U.S. since vaccinations began in the 1960s. A rubella infection during pregnancy can have devastating consequences for the baby. For this reason, pregnant mothers should always be tested early on to make sure that they have been vaccinated and are effectively immune to the rubella virus. For those mothers that were not vaccinated during childhood, a vaccination at the start of pregnancy can be administered.
• Chicken Pox (Varicella): Varicella (commonly known as Chicken Pox) is a well-known childhood virus that typically goes away on its own without any long-term harm. However, varicella is only harmless during mid-childhood. In people older than 16 or babies under the age of 1 (including unborn babies), chicken pox can actually be very dangerous and cause permanent injuries. Pregnant mothers are usually safe if: (1) they actually had chicken pox at some point during childhood, or (2) they were vaccinated for chicken pox. For those pregnant women who have never been vaccinated and never had chickenpox during childhood, it is very important to notify your doctor early on.
• Syphilis: Syphilis (spirochete bacterium) is a well-known STD. Pregnant mothers can potentially give syphilis to their babies during childbirth if they have active vaginal sores. It can also be transferred via the placenta. Syphilis can have devastating effects on newborn infants. Among other things, syphilis in a newborn can result in hearing & vision loss, brain damage, abnormal tooth formation, and even death. Some women may not even realize that they have syphilis because it can be dormant in the body for years. For this reason, all women should be routinely tested for syphilis at the start of pregnancy.
• Toxoplasmosis: Toxoplasmosis is parasitic infection originating from Toxoplasma gondii which is the most widespread parasite organism in the world. Toxoplasma gondii is a simple, single-cell organism that can be found in uncooked meat, certain types of soil, and cat poop. Most people routinely carry toxoplasma gondii somewhere on their bodies but a normal functioning immune system effectively blocks it from causing any harm. A toxoplasmosis infection in a pregnant mother can be dangerous because if transferred to her baby it can interrupt fetal development and result in major birth injuries including vision and hearing loss or brain damage.
• Hepatitis B: Hepatitis b is a complex type of virus that is exceedingly dangerous if transferred to a newborn baby during childbirth. If a baby gets hepatitis b from the mother during delivery it will almost always result in destructive long-term health issues including liver failure and cancer. Early testing for HPV is very important during prenatal care.
• Listeriosis: Listeriosis is a type of infection triggered by listeria, a bacteria that thrives in raw foods. Listeriosis symptoms are similar to the flu such as nausea and fever. Normally a listeria infection is not a major concern but when it occurs during pregnancy is creates very serious risks. Listeriosis bacteria can often invade the fetal membranes which tend to wreak havoc on nutrient supply to the developing fetus and can cause major birth injuries including brain damage and death. As long as the infection is quickly diagnosed it can be easily treated with antibiotics.

The take-home message here is that maternal infections are closely correlated bad outcomes: low Apgar scores, neonatal seizures, and the need for resuscitate the child. Doctors need to be diligent in diagnosing and treating maternal infections to protect the mother and child.