Impact of fetal and neonatal viral (and parasitic) infections on later development and disease outcome.
It is estimated that there are 4 million neonatal deaths and an equal number of stillbirths annually, the majority in the developing world. Neonatal deaths account for one third of deaths in children less than 5 years of age, and at least one third of neonatal deaths are related to infections. Infections also account for 80% of deaths in the postneonatal period through 5 years of age. There are several viral and parasitic infections which produce fetal and neonatal morbidity and mortality. Neonatal infections occur during one or more perinatal periods: in utero (congenital), intrapartum (during labor and delivery), and early or late postpartum. Here the term perinatal refers to all of these stages of fetal or neonatal infections. The mechanisms of perinatal viral and parasitic infections vary depending on the specific pathogen, however, all begin with maternal infection. Following maternal infection, organisms may produce indirect placental infection with or without fetal infection, direct fetal or neonatal infection, or primary maternal infection and subsequent perinatal sequelae without either placental or fetal infection. Some pathogens may produce infections by more than one mechanism. This brief report will provide an overview of the pathogenesis, general outcomes, and known pathogens associated with perinatal viral and parasitic infections.
Maldonado
Yvonne A
YA
Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA. bonniem@stanford.edu
D002657:Child Development; D005260:Female; D005313:Fetal Death / Q000382:microbiology* / Q000469:parasitology*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000469:parasitology / Q000503:physiopathology* / Q000821:virology; D015597:Pregnancy Complications, Parasitic / Q000469:parasitology / Q000503:physiopathology* / Q000821:virology; D011256:Pregnancy Outcome; D018570:Risk Assessment; D019562:Viral Load