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32 - Neurological sequelae of congenital perinatal infection

from Section 4 - Specific conditions associated with fetal and neonatal brain injury

Published online by Cambridge University Press:  12 January 2010

By
Rima Hanna-Wakim ,
Andrea Enright  and
Kathleen Gutierrez
Edited by
David K. Stevenson ,
William E. Benitz ,
Philip Sunshine ,
Susan R. Hintz  and
Maurice L. Druzin
David K. Stevenson
Affiliation:
Stanford University School of Medicine, California
William E. Benitz
Affiliation:
Stanford University School of Medicine, California
Philip Sunshine
Affiliation:
Stanford University School of Medicine, California
Susan R. Hintz
Affiliation:
Stanford University School of Medicine, California
Maurice L. Druzin
Affiliation:
Stanford University School of Medicine, California
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Summary

Introduction

Maternal infections, contracted during pregnancy, may be without fetal consequence or they may have serious adverse effects on the fetus. These adverse effects may include fetal death, stillbirth, intrauterine growth restriction, or congenital infection. Congenitally infected neonates may be symptomatic or asymptomatic at birth. Those who are symptomatic at birth generally have significant long-term sequelae. Those who are asymptomatic at birth may never manifest evidence of damage or they may develop clinically evident sequelae later in life. The overwhelming morbidity attributable to congenital infections is borne by this latter group.

The following chapter will discuss the neurologic consequences of congenital infections. The specific infectious agents that will be discussed are often referred to as the TORCH agents: T represents the parasite Toxoplasma gondii; O represents other agents such as varicella-zoster virus (VZV), human immunodeficiency virus (HIV), and Treponema pallidum (syphilis); R represents rubella virus; C represents cytomegalovirus (CMV); and H represents herpes simplex virus (HSV). With the exception of HSV, the major clinical impact of these agents results from exposure in utero. Morbidity and mortality attributable to neonatal HSV infection usually result from infection contracted at delivery.

Perinatal HIV infection is discussed in Chapter 33.

Type
Chapter
Information
Fetal and Neonatal Brain Injury , pp. 361 - 377
Publisher: Cambridge University Press
Print publication year: 2009

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