Genital infections and reproductive health: infertility and morbidity of mother and child in developing countries.

Genital infections in impoverished countries take a heavy toll both in the etiology of childlessness and in pregnancy-related morbidity, both for the carrier (mother) and the passenger (fetus/newborn). Tubal damage is by far the most common single etiology in cases of childlessness. Among the three factors principally contributing to childlessness, infertility, pregnancy wastage and child loss, tubal infertility is the predominant one. Prevalence figures of N. gonorrhoeae among women in reproductive ages range between 5 and 15% in several countries. Similar figures prevail among pregnant/puerperal women. Preliminary figures indicate that prevalence of Chlamydia trachomatis is similar. Genitally acquired infections during pregnancy contribute to pregnancy wastage in the second and third trimesters of pregnancy. There is virtually no data to support that HBV, HSV and HPV significantly contribute to transmitted intra-uterine disease leading to pregnancy wastage. In the third category of childlessness, child loss, HSV and HIV play a well-known role. Maternal and neonatal morbidity is adversely affected by genital infections acquired during pregnancy. While hepatitis in some places is an important contributor to maternal mortality and morbidity, other viral diseases like HSV and HPV do not appear important in pregnancy-related maternal morbidity. Gonorrhea and chlamydia infection give few maternal problems during pregnancy but may be more important as a cause of puerperal endometritis-myometritis, which constitutes one of the leading causes of maternal death in many developing countries. The fetal/neonatal infant morbidity is affected by gonorrhea and chlamydia infection, while HSV is less frequent but extremely serious when it appears.(ABSTRACT TRUNCATED AT 250 WORDS)