Vertical transmission
from mothers to their infants has been reported.
Transmission in the
third trimester has been reported (2).
Fetal infection in the
third trimester is common in endemic areas, and results in significant
perinatal morbidity and mortality (2).
Parainfluenza Virus type
3.
Viruses has been
isolated from bovine fetuses (3), abortions and stillbirths (4).
May be associated with
fetal hydrocephalus when associated with severe infection in the first
trimester (5).
Hepatitis C.
Vertical transmission
of hepatitis C virus occurs with published rates of 0-4% to 50% depending
on the titres of the maternal viremia (6-8).
Perinatal acquired
infection of hepatitis C may be enhanced by the co-existing presence of
HIV infection in the mother (9,10).
Lyme
Disease (Borrelia burgdorferi).
Placental
transmission of the causative agent and a higher frequency of CHD in the
offspring of women with Lyme disease have been described (11).
One
large cross-sectional study found a higher incidence of CHD in Lyme
endemic regions, but could not demonstrate a correlation between maternal
Lyme disease and CHD in their offspring (12).
Strobino
et.al. retrospectively examined the same endemic population and concluded
that a mother with exposure to tick bites or with the diagnosis of Lyme
disease did not have an increased risk of delivering a child with CHD
(13).
Syphillis.
Incidence
in USA in 1997 was 3.2 per 100,000 (14).
Maternal
syphilis is highly transmittable to the fetus, and associated with (15):
50%
rate of perinatal demise.
Preterm
delivery.
Fetal
hydrops.
Congenital
infection.
Congenital
syphilis can affect any organ in the body including the myocardium.
Maternal
screening and adequate treatment can almost eliminate the risk of fetal
transmission (16).
Coxsackie virus.
The enteroviruses,
specifically coxsackie group A and b (types 2,3,4 and 5) are the most
common causes of myocarditis in children and adults, but disease in the
fetus and neonate is not well documented.
Intrauterine infection
often results in abortion, stillbirth or neonatal demise (17).
The prevalence of
maternal coxsackie infection, and the risk of fetal transmission is
difficult to determine, as the disease is often asymptomatic or
self-limiting in the mother, and serologic confirmation is not standard.
In general,
transplacental transmission is rare, and the extent of the fetal disease
is related to the degree of viremia, the virulence of the strain, and the
presence of specific receptors on fetal tissues (17).
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MMWR 1997;46:346.