Who is behind perinatal infections?

2023-12-21 08:24:57

Who is behind perinatal infections?

“Mothers naturally protect their children through the envelopes of the amniotic membranes, preserving a relatively sterile environment throughout pregnancy,” indicates Dr. Manuel Sánchez Luna, head of the Neonatology Service at the Gregorio Marañón General University Hospital. from Madrid.

“But if an infectious agent, a pathogen, is able to cross these envelopes, the placenta or reach the fetus through the blood, especially in the earliest stages of pregnancy, we will face a devastating risk,” he also emphasizes. President of seNeo.

The earlier the infection, the greater the risk of intrauterine death of the future baby or suffering very serious consequences. When infections occur closer to birth, different clinical pictures are recorded.

“From a smaller number of malformations to serious processes that can lead to late fetal death or condition the life of a newborn with very serious physical problems,” specifies the neonatologist.

Prevention and more prevention of perinatal infections

Embryonic and fetal development, also during childbirth, represents a certain risk for the baby against various infections, especially bacteria, the leading cause of mortality in countries in the process of economic and social development, especially in newborns.

Bacterial infections are generally responsible for serious symptoms of generalized involvement and sometimes infections of the central nervous system.

“Bacterial sepsis has always been a workhorse for those of us who work to prevent problems in newborns. We have developed strategies with fantastic results to reduce bacterial infections in our babies,” attests Dr. Sánchez Luna.

“We must mention the diagnostic tests and treatments, especially against colonization by the bacteria group B streptococcus (EGB), “which was the primary cause of neonatal sepsis.”

This infection occurs when the baby passes through the birth canal of a woman carrying the bacteria. Can cause meningitis (infection of the tissue that covers the brain and spinal cord and pneumonia (lung infection) and infection of the skin and other soft tissues.

Early detection of the bacteria through vagino-rectal screening between weeks 35 and 37 of gestation prevents almost all infections in newborns, since infected mothers are treated with penicillin at the start of labor.

“Today, these infections in countries like Spain have practically disappeared and have been displaced by other types of bacteria that fundamentally affect children born prematurely, those born prematurely,” he highlights.

bacteria like Escherichia coli y Listeria monocytogenes They can also cause very serious cases of sepsis.

The E. coli It is from the family of Enterobacteriaceae, which are part of the microbiota of the gastrointestinal tract; It is responsible for vertical infections, especially in those born prematurely.

Listeria also causes havoc in premature babies, although it is rare; It is transmitted from foods with raw milk or cheese and other contaminated foods.

The infection by listeriosis during pregnancy it would cause a spontaneous abortion before the 20th week of gestation or premature birth or perinatal mortality (from the 28th to the first week of life).

“And against these infections, unfortunately, we lack the prevention that we have had against group B streptococcus,” he points out.

Perinatal infections caused by parasites make up a special group of infections that affect the mother and consequently her future baby.

One of the most important and most frequent parasites is Toxoplasma gondii. This eukaryotic protozoan, a single-celled organism, is acquired when the pregnant woman enters her circle of influence.

“It is a parasite that is part of the life cycle of animals and the human being is incorporated into that cycle, normally, through the ingestion of contaminated food and drinks:

Eating raw or undercooked meat from infected animals (pork, lamb, etc.). Poorly washed vegetables. Drink water contaminated with this parasite. Using kitchen utensils that were in contact with infected meat (food cutting boards, trays, plates, knives, skewers, forks, etc.). Touching the feces of an infected cat with bare hands.

The baby is at greater risk of infection during the third trimester of pregnancy and less risk in the first, but the effects will be more serious: fetal death or spontaneous abortion.

When the fetus survives, the result is usually severe damage to the central nervous system, liver and blood involvement.

If the infection is acquired late, toxoplasma is capable of producing an infectious condition similar to that produced by bacteria in newborns.

Some of the babies born with toxoplasmosis They do not usually show signs of the disease until adolescence and other adult stages. These people will develop hearing loss, mental disability or eye infections of varying severity.

Future mothers are therefore advised to go to the preconception consultation before getting pregnant. You can check, for example, if there is immunization against toxoplasmosis.

Viral infections are serious before birth. The most prevalent is Cytomegalovirus (CMV), of the genus Herpesvirus. It continues to be a great enemy: maternal infections, infections in the fetus and medium and long-term infections in babies.

“We are increasingly looking for these women, who, if negative, can become positive during pregnancy: we do not have an effective treatment when this pregnant woman is infected with this microorganism,” argues the neonatologist.

Cytomegalovirus is very contagious through urine in daycare centers and schools, or among women who work in the health sector.

It is present in many body fluids. Pregnant women can unknowingly transmit the virus to their fetus, causing a congenital infection.

“In women who have not suffered cytomegalovirus, infection during pregnancy can cause miscarriages, fetal death, serious malformations, especially in the brain, eye damage to the retina and deafness,” he relates.

“When the infection is late, it is possible that the baby remains asymptomatic, but with sensorineural deafness. Hearing screening will help detect the problem early. Other times, however, deafness can appear in later stages of child development,” she warns.

Postnatal treatment, although effective in reducing medium and long-term consequences, is not so effective in avoiding the consequences of infection before birth.

In the case of herpes genital We are talking about a high risk factor for the fetus, potentially fatal, especially during childbirth. The virus causes brain damage, blindness and damage to different organs.

Other viral infections, such as those caused by chickenpox, zica, human parvovirus type B19 or hepatitis B, are less common but equally serious.

“I do not want to end this video blog without highlighting the number of risks that surround women of childbearing age or during pregnancy due to sexually transmitted infections, which are still very prevalent,” he emphasizes.

“Many times, since these infections are not very symptomatic, women will not go to the doctor, they will not be treated and they may suffer extraordinarily serious problems; and not only them, but also their children, before, during and after birth,”

Bacterial infections through this route of sexual transmission (STI) are very striking, such as clamidia, the gonorrhea o to syphilis: causing premature births, low birth weight of the baby or various lung and eye complications, even blindness.

“In short, there is nothing like prevention, knowledge and good control and monitoring of mothers who intend to become pregnant or at any stage of pregnancy. They have at their disposal the obstetrics and gynecology teams of the National Health System,” concludes the Dr. Manuel Sanchez Luna.