Vertically transmitted infection

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Vertically transmitted infection refers to an infection that is passed from the mother to her baby during the period immediately before and after birth. The transmission can occur across the placenta, in the breast milk, or through direct contact during or after birth. Understanding and managing vertically transmitted infections is a critical aspect of neonatology and obstetrics.

Mechanisms of Transmission

Vertically transmitted infections can be passed through several mechanisms:

• Transplacental transmission: The pathogen crosses the placenta during pregnancy, infecting the fetus. This can occur at any stage of pregnancy but is more common during the first trimester when the placental barrier is not fully developed.
• Peripartum transmission: Infection occurs during the process of childbirth, either through exposure to maternal blood and bodily fluids or through the passage of the baby through the birth canal.
• Postnatal transmission: This occurs when the infant is exposed to infectious agents in the mother's breast milk or through direct contact after birth.

Common Vertically Transmitted Infections

Several infections are commonly transmitted from mother to child:

• HIV/AIDS: Human Immunodeficiency Virus (HIV) can be transmitted from mother to child during pregnancy, delivery, or breastfeeding.
• Hepatitis B and Hepatitis C: These liver infections can be passed from mother to baby, particularly during birth.
• Herpes Simplex Virus (HSV): HSV can be transmitted to the infant if the mother has an active genital herpes infection during delivery.
• Syphilis: This bacterial infection can cross the placenta and infect the fetus during pregnancy.
• Toxoplasmosis: Caused by a parasite, toxoplasmosis can be transmitted if the mother becomes infected during pregnancy.
• Rubella (German measles): If a woman contracts rubella during pregnancy, it can cause serious birth defects or miscarriage.
• Cytomegalovirus (CMV): A common virus that can be passed from a pregnant woman to her fetus, potentially leading to birth defects or developmental delays.

Prevention and Treatment

Prevention and treatment strategies for vertically transmitted infections include:

• Screening and Vaccination: Pregnant women are often screened for certain infections, such as HIV, hepatitis B, and syphilis, early in their pregnancy. Vaccinations are also recommended for some infections, like hepatitis B and rubella, before or during pregnancy.
• Antiviral or Antibiotic Treatment: In some cases, administering antiviral or antibiotic medications during pregnancy can reduce the risk of transmitting the infection to the baby.
• Cesarean Delivery: For women with active genital herpes or HIV, a cesarean delivery can reduce the risk of transmitting the infection during birth.
• Avoiding Breastfeeding: In cases where the mother has HIV or HTLV-1, avoiding breastfeeding can prevent postnatal transmission of the virus to the infant.

Conclusion

Vertically transmitted infections represent a significant risk to neonatal health, but with proper screening, preventive measures, and treatment, the risk of transmission can be greatly reduced. Ongoing research and public health efforts continue to focus on reducing the incidence of these infections and improving outcomes for affected infants.