Perinatal infections and fetal/neonatal brain injury.
OBJECTIVE
Fetal and newborn brain injury causes lifelong morbidity for the survivors, with high emotional costs to the individual and the family plus a heavy economic burden for society. This is timely and relevant. Techniques are now available to prevent, detect, and treat those central nervous injuries that result from infection. If instituted, these would have beneficial results for both newborn survival and morbidity.


RESULTS
The new developments and prevention of adverse impacts of maternal infections due to Rubella, Group B Streptococcus, cytomegalovirus, toxoplasmosis, and chorioamnionitis are discussed.


CONCLUSIONS
Rubella immunization has been a success in the USA with virtual elimination of wild virus infection. Broader screening policies need to be instituted to lower the morbidities associated with cytomegalovirus and toxoplasmosis. Alternatives to maternal antibiotic prophylaxis in newborn Group B Streptococcus infection need to be evaluated and implemented when proven effective. The most beneficial treatment protocol for chorioamnionitis needs to be determined by prospective study and then instituted. To date, the combination of maternal antibiotics and steroids appears most promising.
Ledger
William J
WJ
Weill Medical College of Cornell University, New York, New York 10065, USA. wjledger@med.cornell.edu
D000890:Anti-Infective Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001921:Brain / Q000382:microbiology / Q000821:virology; D001927:Brain Diseases / Q000382:microbiology / Q000821:virology; D002821:Chorioamnionitis / Q000382:microbiology* / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital / Q000517:prevention & control; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012409:Rubella / Q000151:congenital / Q000517:prevention & control; D013290:Streptococcal Infections / Q000150:complications / Q000151:congenital / Q000517:prevention & control; D013292:Streptococcus agalactiae; D014123:Toxoplasmosis / Q000150:complications / Q000517:prevention & control
D000890:Anti-Infective Agents