Microcephaly can be caused by many disorders including genetic abnormalities The head is small because it does not develop normally. Zika virus infection can also cause eye abnormalities in the baby. The Zika virus is spread by mosquitoes, but it can also be spread through sexual intercourse, through blood transfusions, and from a pregnant woman to her baby before or during birth. Infections that are not transmitted sexually and that can cause problems include the following:.
German measles rubella Rubella Rubella is a contagious viral infection that typically causes mild symptoms, such as joint pain and a rash, but can cause severe birth defects if the mother becomes infected with rubella during Newborns may be small because their parents Some are severe, but many are not.
Defects may involve abnormal formation of the heart's walls or valves or of the blood vessels that enter Cytomegalovirus infection Cytomegalovirus CMV Infection Cytomegalovirus infection is a common herpesvirus infection with a wide range of symptoms: from no symptoms to fever and fatigue resembling infectious mononucleosis to severe symptoms involving Chickenpox Chickenpox Chickenpox is a highly contagious viral infection with the varicella-zoster virus that causes a characteristic itchy rash, consisting of small, raised, blistered, or crusted spots.
It may damage the eyes of the fetus or cause defects of the limbs Introduction to Birth Defects of the Face, Bones, Joints, and Muscles Birth defects of the face and limbs are fairly common. They may involve only a specific body part, such as the mouth cleft lip or cleft palate or foot clubfoot.
Or they may be part of a Toxoplasmosis Toxoplasmosis Toxoplasmosis is infection caused by the single-celled protozoan parasite Toxoplasma gondii. Infection occurs when people unknowingly ingest toxoplasma cysts from cat feces or eat contaminated Listeriosis Listeriosis Listeriosis is infection caused by the gram-positive bacteria Listeria monocytogenes, usually when contaminated food is eaten.
People may consume the bacteria in contaminated dairy products Pregnancy complications are problems that occur only during pregnancy. They may affect the woman, the fetus, or both and may occur Newborns may have the infection, but symptoms may be delayed until several weeks after birth.
Bacterial infections of the vagina such as bacterial vaginosis Bacterial Vaginosis BV Bacterial vaginosis is a vaginal infection that occurs when the balance of bacteria in the vagina is altered.
Women who have a sexually transmitted disease, who have several sex partners, or Urinary tract infections Overview of Urinary Tract Infections UTIs In healthy people, urine in the bladder is sterile—no bacteria or other infectious organisms are present.
You'll be offered a confidential HIV human immunodeficiency virus test as part of your routine antenatal care.
Your midwife or doctor will discuss the test with you, and counselling will be available if the result is positive. Read more about screening for HIV in pregnancy. Current evidence suggests that if you're HIV positive, in good health and without symptoms of the infection you're unlikely to be adversely affected by pregnancy. If you're diagnosed with HIV, you and your doctor will need to discuss the management of your pregnancy and birth to reduce the risk of infection for your baby.
Treatment in pregnancy greatly reduces the risk of passing on HIV to the baby — from 1 in 4 to fewer than 1 in Your baby will be tested for HIV at birth and at regular intervals for 18 months. You'll be advised not to breastfeed or chestfeed, as HIV can be transmitted to your baby in this way. If you're HIV positive, talk to your doctor or midwife about your own health and the options open to you. Slapped cheek syndrome is common in children. It typically causes a rash on the face.
If you come into contact with anyone who is infected, you should talk to your doctor, who can carry out a blood test to check whether you're immune. In most cases, the baby is not affected if you have slapped cheek syndrome. But if you develop rubella in the first 4 months of pregnancy, it can lead to serious problems, including birth defects and miscarriage. It's unlikely you have rubella in these circumstances, but you may need a blood test to check.
If you're pregnant and are not sure whether you've had 2 doses of the MMR vaccine, ask your GP practice to check your vaccination history. If you have not had both doses or there's no record, you should ask for the vaccine when you go for your 6-week postnatal check after the birth. This will protect you in any future pregnancies. STIs often have no symptoms, so you may not know if you have one.
However, many STIs can affect your baby's health both during pregnancy and after the birth. If you have any reason to believe you or your partner may have an STI, go for a check-up as soon as possible.
You can ask your GP or midwife. If you prefer, you can go to a sexual health clinic. Confidentiality is guaranteed. Find a sexual health service near you. These demands can also worsen complications.
For example, if a pregnant person develops pneumonia from the flu, they may have more difficulty breathing because of the increased demands the fetus places on the heart and lungs. Some medications that can effectively treat common infections may be less safe during pregnancy.
So it is essential that pregnant people who have an infection talk to their doctor or midwife to weigh up the benefits and risks of various treatment options. Numerous infections can affect the developing baby. However, it is difficult for doctors to tell whether and to what extent a fetus will be affected. According to the National Institutes of Health NIH , infections that are known to harm the developing baby include, but are not exclusive to:.
Zika infection, which is a disease carried by mosquitoes, may cause birth abnormalities and increase the risk for stillbirths and miscarriages in those who have the virus. However, it is unclear why some fetuses are affected, and others are not. Other infections may also harm a developing baby, depending on the overall health of the pregnant person, when the infection developed, and whether the person has received treatment.
The Centers for Disease Control and Prevention CDC provide some strategies to reduce the risk of developing an infection during pregnancy, including:. Most people who experience an infection during pregnancy will not experience complications. Prompt treatment increases the likelihood of a healthy birth. Anyone who experiences any unusual symptoms during their pregnancy should talk to their doctor or midwife.
Prenatal care is also crucial since it can detect certain infections even before they cause symptoms. Learn about the different types of finger infections and what may cause them. How are the infections diagnosed and can they be prevented? During a healthy pregnancy, it is typically safe to continue having sex. In fact, sex during pregnancy can have various benefits for the woman…. Sneezing during pregnancy is common.
The score of random studies was further evaluated by two more individuals. An overview of all the studies analysed is presented in Supplementary Table SI , including pathogen s investigated, outcome of the study and an estimation on the strength of each study, as described in Methods.
Some of the most common caveats addressed in this review were variation in sample size and detection techniques, whether multivariate analysis was implemented or not and variation in study design.
In healthy women, the normal genital tract flora consists for the most part of Lactobacillus species bacteria Lamont et al. Other potentially virulent organisms, such as Gardnerella vaginalis, group B streptococci , Staphylococcus aureus, Ureaplasma urealyticum U. Change of sexual partner, a recent pregnancy, use of an intrauterine contraceptive device and antibiotic treatment have been identified as plausible causes of BV Hay, ; Smart, BV has been associated with premature delivery Hay et al.
In a retrospective study from Albania, U. The prevalence of both pathogens was significantly higher among women with a history of miscarriage U. This study however has some weaknesses, as it is not clear whether the comparisons made were with non-infected women with a miscarriage history or non-infected women with no miscarriage history and the method by which prevalence of microbes was tested is not specified.
Data on the prevalence of group B streptococci and pregnancy outcome in Brazilian women with gestational age between 35 and 37 weeks was published in Rocchetti et al. Overall, Association of BV and particularly M. In total 50 pregnant women with BV symptoms were tested for M. The pregnancy outcomes of 50 asymptomatic pregnant women were used as controls.
Miscarriage was reported in 12 symptomatic women, in 8 of which M. Furthermore, comparative analysis between the two groups was not carried out. Second most common pathogens were M. In a further study using a cohort of Belgian pregnant women following microbiological evaluation of vaginal flora, 8.
An absence of lactobacilli was also associated with miscarriage less than 25 weeks; OR 4. These studies indicate an association of BV with miscarriage. As BV is treatable, screening programmes for pregnant women can be used to prevent adverse pregnancy outcome.
Current guidelines from the USA advise against screening asymptomatic pregnant women U. Preventive Services, A recent Cochrane review, including women in 21 trials, found decreased risk of late miscarriage when antibiotic treatment was administered relative risk RR 0.
As the authors highlight, further studies are required to establish the effect of screening programmes to prevent adverse pregnancy outcomes Brocklehurst et al. Bacteria of the genus Brucella can infect a variety of wild and domesticated mammals. Cattle and deer are susceptible to Brucella abortus B. Humans can contract infection via consumption of unpasteurised dairy products Corbel, Infection is detected via bacterial isolation from blood samples or serology CDC—Centre for Disease and Prevention, a.
Kurdoglu and colleagues in Turkey Kurdoglu et al. The researchers concluded that The seroprevalence of brucellosis among miscarriage cases and control pregnant Jordanian women with no history of miscarriage consecutively recruited, matched for age, socioeconomic status and area of residence, was not significantly different Abo-shehada and Abu-Halaweh, The evidence suggests brucellosis is still a risk factor for miscarriage in areas where the infection is endemic in farm animals.
This is in accordance with older studies that have reported high miscarriage rates among women with brucellosis Lulu et al. Chlamydia trachomatis , an obligate intracellular bacterium, is the most common sexually transmitted bacterial disease worldwide Howie et al. The prevalence of the disease is high, estimated at million new cases in worldwide World Health Organisation, Though in women it is often asymptomatic, untreated C.
Chlamydia trachomatis infection is a known risk factor for ectopic pregnancy and preterm birth Martin et al. Diagnosis is carried out by PCR on vaginal swab samples and treatment includes the administration of antibiotics, such as tetracyclines, azithromycin or erythromycin Brocklehurst and Rooney, ; MedlinePlus, The most recent case—control study investigating a potential association of C.
Immunoglobulin Ig G antibodies against C. The same pattern was observed for IgA antibodies only after adjustment for age, origin, education and number of sexual partners. Furthermore, C. Subsequently, an observational study from Finland on women with genital tract infections has suggested that late complications can occur in C.
In a study from Serbia, The authors suggest an association between persistent C. Chlamydia trachomatis has been studied extensively and a lot of data are available for this infection from over three decades of research.
Contradicting studies have been published, resulting in conflicting evidence regarding the role of C. Taking into account the most recent findings and the increase in screening programmes worldwide, such as the screening offered to all pregnant women in the USA CDC, , public awareness of the possible risk of C. Mycoplasma genitalium is a sexually transmitted bacterium, known to cause urethritis, cervicitis and PID, but infection can also be asymptomatic Taylor-Robinson and Jensen, It has been suggested that M.
The only published study of this infection, is a case—control study from the USA on women with miscarriage before 22 weeks of gestation and healthy pregnant controls, and used data from participants originally enrolled in another study. Overall, M. Q fever is a zoonotic infection, caused by the bacterium Coxiella burnetii Maurin and Raoult, Infection is most commonly observed in humans who come into close proximity to livestock.
Coxiella burnetii is usually transmitted via inhalation of infectious aerosols from animal fluids Maurin and Raoult, ; van der Hoek et al. Infection is asymptomatic in half of all cases in adults but can present as an unspecific illness combined with pneumonia or hepatitis. Recommended treatment in symptomatic adults and children is doxycycline administration. However, as the authors note, studies investigating serological evidence of infection and miscarriage have produced contradictory results.
Screening of pregnant women is not currently recommended in the European Union Munster et al. Two Danish studies, one in and the second in , concluded that C.
Both used randomized sera samples from the Danish National Birth Cohort. The first study was powered to detect whether infection could be associated with miscarriage. The presence of infection was investigated in a case group of women with miscarriage loss of pregnancy prior to 22 weeks of gestation compared with healthy pregnancies.
The second study focused on pregnancy outcomes of women exposed to cattle and sheep high risk of exposure to C. Nielsen and colleagues Nielsen et al. These results suggest that, despite presence of C. Syphilis is a bacterial infection that can be transmitted sexually or via contact with the blood of an infected person. It is caused by Treponema pallidum , diagnosed using PCR, and is treated with antibiotics Cohen et al.
Stage one symptoms include a highly contagious sore that develops during stage two to a rash accompanied by sore throat. The third and final stage is tertiary syphilis, which is not contagious but is very harmful. Casal and colleagues Casal et al. The cases consisted of women positive for syphilis, with live births and 68 who had an adverse pregnancy outcome.
This included miscarriage, stillbirth and neonatal death grouped together. The control group of women negative for syphilis included women who had live births and 83 with adverse pregnancy outcome. Syphilis was significantly associated with history of miscarriage OR 3. Most of the pregnancies resulting in live births were not completely asymptomatic when infection was present, resulting in outcomes such as prematurity, low birthweight and respiratory problems, among others.
They also observed that maternal syphilis was associated with illegal drugs, alcohol, no counselling on syphilis, sexual activity initiation at 16 years of age or younger, two or more sexual partners during the preceding 1. A study from China reported that, following a screening programme aiming to prevent mother-to-child syphilis transmission, the adverse pregnancy outcomes including miscarriage were reduced from The effect of syphilis on pregnancy has been a subject of interest for almost years; general consensus is that syphilis can have a devastating effect on fetuses resulting in miscarriage, stillbirth and congenital transmission Temmerman et al.
CMV infects mostly myeloid cells and is never eradicated from the body Koch et al. Herpes viruses can be diagnosed using PCR in sera samples Singh et al.
The authors concluded that HSV seems to have a role in early miscarriage, although they did not distinguish between the two types of HSV. These data are supported by a more recent study from Korea Kim, et al. Most of the women in both groups also tested positive for rubella, varicella zoster HHV-3 and hepatitis B HEPB , however the authors adjusted for this. Of HSV-2 seropositive women, A possible association of HSV1 and HSV2 with miscarriage cannot be ascertained from these reports and further studies are required.
Hadar and colleagues studied a group of seropositive 59 women with peri-conceptional CMV infection, which occurred between 4 weeks prior to the last reported menstrual period and up to 3 weeks after the expected date of the period. Out of these women, four had miscarriages before undergoing amniocentesis to confirm intrauterine infection. The remaining patients either elected to terminate the pregnancy or gave birth to live infants. No conclusion could be drawn with regards to miscarriage association as no controls were included in this study Hadar et al.
Data from a Malaysian study Saraswathy et al. Despite the lack of recent studies supporting an association of CMV with miscarriage, in vitro studies have shown that CMV infection can result in placental dysfunctions see below.
However, further studies are required to elucidate the true role of CMV in adverse pregnancy outcomes. Human papillomaviruses HPV comprise a group of over different types of small DNA viruses some of which cause common sexually transmitted infections Cutts et al.
Sexually transmitted HPV infection has a prevalence rate of The vast majority of infections are asymptomatic and clear naturally without causing long-term disease and a vaccine is now available for types 6, 11, 16 and 18 Cutts et al.
HPV infection cannot be diagnosed by blood tests, however PCR on cervical cell samples is used to determine specific viral genotypes following a positive Papanicolaou PAP -test Molijn et al. The results of recent studies into the effects of HPV infection upon miscarriage are contradictory Perino et al.
A total of Both of these studies suggest that HPV infection in women has no effect on pregnancy outcome, although no more than women were examined in either study. Conversely, results from a study significantly associated male partner HPV infection with miscarriage rate in couples attending IVF clinics in Italy These studies present contradictory data, however the first two examined infection in female partners whereas the second one investigated male partners.
Interestingly, an older study Hermonat et al. Further well-designed, adequately powered studies are required to fully elucidate the role of HPV as a potential risk factor for miscarriage, whilst considering the role of an infected male partner as there are indications of a potential role in early miscarriage Garolla et al.
Parvoviruses belong to the Parvoviridae family and are very small single stranded DNA viruses that infect invertebrates and vertebrates Cotmore et al. Antibodies against several serotypes of AAV show infection in various tissues, but it is asymptomatic Gao et al.
AAV needs the help of a helper virus, adenovirus, to replicate. No association of AAV infection with serotypes 2, 3 and 5 with recurrent miscarriage defined as two or more was found in couples with subfertility Schlehofer et al. A total of semen samples as well as endocervical samples from couples attending a fertility clinic were tested for the presence of AAV DNA and No associations with other infectious pathogens, semen quality or subsequent fertility issues were indicated. The authors grouped cases with confirmed type of abortion and observed The classification of samples used as well as definition of the various groups compared in this study are unclear from the paper description, thus interpretation is challenging.
Despite the detection of AAV DNA in some miscarriage cases, there is inconclusive evidence for a role for this virus in miscarriage. A recent study from Northern Ireland examined women of reproductive age and Though fetal loss was reported in infected women with confirmed presence of the virus in miscarried fetuses, no increased association with miscarriage was observed. In an earlier study of 72 pregnant women with B19V, it was noted that the risk of vertical transmission is higher if infection occurs by gestational week No conclusions regarding the association were reached by the researchers Bonvicini et al.
A higher percentage of IgM antibodies indicating recent infection was observed in women with adverse pregnancy outcomes Interestingly, anti B19V IgG antibodies were higher in controls than cases An important limitation of this study is that the adverse pregnancy outcome included miscarriage, non-immune hydrops fetalis and intrauterine fetal death, thus the association of miscarriage alone with B19V is not clear.
In a study from Nigeria, B19V prevalence among pregnant women was estimated at From the above, it is evident that a case—control study on women with miscarriage versus healthy pregnant controls, statistically powered to elucidate the role of B19V in miscarriage is required, as there are indications of high prevalence in pregnancy and fetal infection.
HIV is a retrovirus, and is most commonly transmitted via unprotected sexual intercourse or sharing of equipment for intravenous drug use. Anti-retroviral treatment delays the onset of severe symptoms and protects the patient from opportunistic infections, which are the main cause of death among HIV-positive patients Dybul et al. A study from Nigeria examined pregnancies in women positive for HIV compared with pregnant non-infected women from the same hospitals.
This association was retained after adjustment for several confounding variables such as age, parity, history of miscarriage and others. The infected women in this study were all receiving anti-retroviral treatment, however different regimes were used during the years in which the study was conducted. Limitations of this study include the number of controls not being clearly stated and lack of testing for other sexually transmitted diseases Ezechi et al.
The ratio of miscarriages to live births was 3. The women were recruited during both first and second trimesters and none of the women who miscarried had received anti-retroviral treatment. The study did not compare the cases with uninfected pregnant women. Of note, fetal death after 22 weeks was classified as stillbirth. Therefore, no conclusions regarding miscarriage specifically can be drawn from this study. HIV status was associated with miscarriage in a study of 1, pregnant women from Uganda De Beaudrap et al.
Furthermore, as stillbirth and miscarriage were grouped together as one outcome, no definite conclusions regarding miscarriage can be drawn from this study. To summarize, evidence suggests that HIV infection negatively affects pregnancy; however, anti-retroviral treatment can reduce the risk of adverse outcomes Zolopa et al. The presence of multiple diseases could further compromise a pregnancy. As most of the studies suggest, consultation and monitoring of HIV-positive women who wish to become pregnant is desirable.
Antibodies against the virus can be detected using sera samples and PCR, urine cytology and viral immunostaining Masutani, Recent studies have investigated a potential role of BK virus infection on adverse pregnancy outcomes. A study on patients with unexplained villitis infection of the placental villi associated with adverse pregnancy outcomes detected no BK in placenta from miscarriages Cajaiba et al. It seems therefore more suitable to address these cases as stillbirths, not miscarriages.
In another study from Italy, samples from five miscarried fetuses with chorioamnionitis and miscarriages due to chromosomal abnormalities controls , BK was detected in fetal organs Boldorini et al. Though this provides possible proof of vertical transmission of the virus, as it was detected in four out of five chromosomally abnormal controls and three out of five cases, the authors concluded that BK infection does not have a role in miscarriage.
In accordance with the first study, the fetuses were between the 15th and the 28th week of gestation, so some of them were stillbirths according to our review's classification.
Moreover, the fetuses were not matched for gestational age. In both studies, the numbers were small and no early miscarriages were tested. The question whether BK virus could be associated with miscarriage requires therefore further investigation.
Dengue fever is a disease caused by four viruses of the single stranded RNA flaviviridae genus DEN , transmitted via mosquito bites usually in tropical and sub-tropical climates worldwide.
WHO estimates 40—50 million new cases every year. Dengue is a flu-like illness with no vaccination and treatment currently available. The role of dengue fever in miscarriage was examined in a prospective study from Malaysia on women with miscarriage up to 22 weeks of gestation and healthy pregnant controls.
This study found significant association of recent dengue fever infection with miscarriage after adjusting for confounders such as maternal age, gestational age, parity and ethnicity 5. In a case series report from Sri Lanka, two out of fifteen pregnant women experienced fetal death at 24 and 35 weeks of gestation, however the study provides no evidence of vertical transmission to the fetuses Kariyawasam and Senanayake, In another case series report from French Guiana the authors reported two late miscarriages in 53 pregnant women with dengue fever.
However, the infection could not be connected to the adverse pregnancy outcome Basurko et al. A systematic review on 30 studies concluded that it is unclear whether dengue fever is associated with adverse pregnancy outcomes Pouliot et al.
Based on recent evidence however, we can conclude that dengue fever seems to be a risk factor for miscarriage; therefore it is advisable to raise awareness regarding protective measures in high-risk areas and for people travelling to those areas. Both viruses cause liver inflammation and disease and are both found in body fluids.
Both diseases are diagnosed using blood serological tests Gretch, ; Krajden et al. In a case—control study from China, 75 couples that received assisted reproduction treatment were followed up, divided into a group with one partner diagnosed with chronic HEPB infection and a control group with both parents seronegative for HEPB Ye et al.
These results suggest a possible role of chronic HEPB infection in miscarriage. No association of infection with miscarriage was apparent after multivariate analysis Murad et al. These studies raise questions regarding the role of persistent HEPB infection during pregnancy. Rubella is a mild childhood disease that, if acquired during the first 16 weeks of gestation, can result in miscarriage and serious fetal defects Banatvala and Brown, A vaccine has been available for several years resulting in significant reduction in new cases according to the latest WHO progress report Reef et al.
Regardless of this progress, it is important to be aware that there remain a number of unvaccinated pregnant women in Europe and worldwide that do not have access to vaccination and who are still at risk of adverse pregnancy outcome due to rubella Metcalf et al. A study of the Influenza pandemic concluded that it resulted in a decrease of live births due not only to high mortality but also to an increase of early miscarriages in pregnant women who were infected by the virus Bloom-Feshbach et al.
In a case series report regarding the H1N1 Influenza A pandemic, six women were admitted to intensive care and had adverse pregnancy outcomes, however only one seriously ill patient had a spontaneous abortion as four cases occurred during the third trimester Oluyomi-Obi et al.
Malaria is caused by infection with protozoa of the genus Plasmodium P. Symptoms include fever, sweats, headache and diarrhoea and can be treated using different drugs depending on the symptoms and the specific pathogen causing the disease such as atovaquone plus proguanil or doxycycline Kar and Kar, Malaria parasites are identified by microscopit examination of patients' blood samples.
In , Plasmodium can bind chondroitin sulphate A expressed on trophoblast and this is what causes local parasitaemia in the placenta Agbor-Enoh et al. Maternal disease is most severe in primigravida women, and it reduces with each pregnancy as immunity builds up to those parasites that target the placenta Fried et al.
Women with asymptomatic and symptomatic malaria single episode before 14 weeks of gestation are at a higher risk of miscarriage adjusted OR 2. This study included women with miscarriage and 14 women that gave birth to live babies in Thailand. The risk ratios were not different for both P. De Beaudrap et al.
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