OBJECTIVE: To review current information about congenital and perinatal infections, mainly related to their epidemiology in Brazil, mother-to-infant transmission, diagnosis, treatment and prevention. Particular aspects related to the agents T. pallidum, hepatitis B virus, human immunodeficiency virus, cytomegalovirus and T. gondii were considered. METHODS: The main published papers from the last 10 years were selected from a Medline database electronic search. RESULTS: Congenital or perinatal infections can occur in up to 10% of newborns. Although there are few Brazilian studies, available data suggest their relevance, mainly related to the occurrence of infection due to T. pallidum, HIV and CMV. At least 50% of the infected newborns are asymptomatic. However, because these infections may lead to long term sequelae, it is necessary to early identify infected pregnant women in order to implement specific preventive measures. Presently, laboratory methods for early diagnosis of fetal or neonatal infections are available. They are predominantly based on assays for detection of IgA or IgM specific antibodies and fragments of the microorganism nucleic acids by polymerase chain reaction. The available treatments had only limited success, because they often have failed to substantially modify the prognosis for infected infants. New treatments and outcome studies are needed. CONCLUSIONS: Congenital and perinatal infections are a relevant problem whose main current advances are related to prevention and laboratory diagnostic methods applicable to pregnant women, fetus or infants.
OBJECTIVE: To review current information about congenital and perinatal infections, mainly related to their epidemiology in Brazil, mother-to-infant transmission, diagnosis, treatment and prevention. Particular aspects related to the agents T. pallidum, hepatitis B virus, human immunodeficiency virus, cytomegalovirus and T. gondii were considered. METHODS: The main published papers from the last 10 years were selected from a Medline database electronic search. RESULTS: Congenital or perinatal infections can occur in up to 10% of newborns. Although there are few Brazilian studies, available data suggest their relevance, mainly related to the occurrence of infection due to T. pallidum, HIV and CMV. At least 50% of the infected newborns are asymptomatic. However, because these infections may lead to long term sequelae, it is necessary to early identify infected pregnant women in order to implement specific preventive measures. Presently, laboratory methods for early diagnosis of fetal or neonatal infections are available. They are predominantly based on assays for detection of IgA or IgM specific antibodies and fragments of the microorganism nucleic acids by polymerase chain reaction. The available treatments had only limited success, because they often have failed to substantially modify the prognosis for infected infants. New treatments and outcome studies are needed. CONCLUSIONS: Congenital and perinatal infections are a relevant problem whose main current advances are related to prevention and laboratory diagnostic methods applicable to pregnant women, fetus or infants.
Authors: Vanessa van der Linden; Epitacio Leite Rolim Filho; Otavio Gomes Lins; Ana van der Linden; Maria de Fátima Viana Vasco Aragão; Alessandra Mertens Brainer-Lima; Danielle Di Cavalcanti Sousa Cruz; Maria Angela Wanderley Rocha; Paula Fabiana Sobral da Silva; Maria Durce Costa Gomes Carvalho; Fernando José do Amaral; Joelma Arruda Gomes; Igor Colaço Ribeiro de Medeiros; Camila V Ventura; Regina Coeli Ramos Journal: BMJ Date: 2016-08-09