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Fetal Infections: Rubella, HIV, HCV, HBV, and Human Parvovirus B19

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Neonatology

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Abstract

Congenital rubella (CR) infection leads to damage in over 80% of fetuses during the first trimester of pregnancy, in 25–34% of cases in the second trimester, while no malformations occur in the third trimester CR syndrome is characterized by cardiac, ocular, and hearing defects, although any organ may be affected. All women of child-bearing age should have natural or vaccine-induced immunity to the virus. Mother-to-child transmission (MTCT) of HIV has decreased from 18% down to 1% in bottle-fed infants with adoption of preventive interventions. These include: prenatal antiretroviral (ARV) prophylaxis, administration of ARV during delivery and avoidance of breast feeding. An early combined ARV treatment of HIV-infected infants offers the great benefits of a longer asymptomatic period and of a prolonged survival. No interventions are currently available to prevent MTCT of HCV, that is estimated to be about 5%. The natural history of HCV infection is relatively benign in childhood. More than 90% of HBV exposed infants develop chronic infection. Administration of HBV vaccine and specific immunoglobulins at birth followed by the 3-dose vaccine series has reduced the MTCT rate by about 90%. Primary maternal infection with parvovirus B19 is associated with asymptomatic fetal infection, hydrops fetalis, intrauterine death, and birth defects. In the first and second trimester the MTCT rate is about 30%. In case of hydrops or signs of anemia, intrauterine trasfusions are recommended.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Turin, Regina Margherita Childrens Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy

    Pier Angelo Tovo

  2. Department of Pediatrics, University of Turin, Turin, Italy

    Stefania Bezzio & Clara Gabiano

Authors
  1. Pier Angelo Tovo
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  2. Stefania Bezzio
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  3. Clara Gabiano
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Corresponding author

Correspondence to Pier Angelo Tovo .

Editor information

Editors and Affiliations

  1. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Giuseppe Buonocore

  2. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Rodolfo Bracci

  3. Liverpool Women’s Hospital Neonatal Unit, Liverpool, UK

    Michael Weindling

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Tovo, P.A., Bezzio, S., Gabiano, C. (2018). Fetal Infections: Rubella, HIV, HCV, HBV, and Human Parvovirus B19. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-29489-6_251

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  • DOI: https://doi.org/10.1007/978-3-319-29489-6_251

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