Infections Transmitted to Newborn

Question 1

rubella

Answer 1

• crosses the placenta and causes fetal infection
• can lead to deafness, cataracts, cardiac defects, infecting other adults/infants after birth
• prevention:
  
  • rubella titer (1:8 or less = non-immune
  • rubella vaccination
    
    • 28 days prior to pregnancy
    • NOT during pregnancy

Question 2

herpes simplex virus (HSV)

Answer 2

• no vaginal delivery w/ active lesions
  
  • bright light examination
• transmission to infant
  
  • after ROM
  • during birth
  • placement of an FSE
• 50% infant death rate
• acyclovir prophylaxis

Question 3

hepatitis B

Answer 3

• transmitted via vaginal secretions, breast milk, crosses placenta, and semen
• infant hep B immunization prior to discharge
• if mother hep B positive: HBIG and hep B vaccine administered to neonate w/in 12 hours

Question 4

HIV

Answer 4

• perinatal exposure thru birth
• exposure thru breast milk
• antiretroviral drugs to mother
• infant HIV positive for up to 18 mos
  
  • prophylactic antiretrovirals
  • no breast feeding

Question 5

GBS

Answer 5

• colonization of rectum, vagina, cervix, urethra
• infects infant during birth
  
  • sepsis, meningitis, pneumonia
• culture specimen at 36 weeks
• penicillin (or cephazolin) during labor
• risk for infection:
  
  • prolonged ROM
  • multiple vaginal exams

Question 6

toxoplasmosis

Answer 6

• stay away from cat litter and raw meat

Question 7

listeria

Answer 7

• no lunch meat, sushi, soft cheese

Question 8

newborn risks with chlamydia

Answer 8

• ophthalmia neonatorium
  
  • subsequent blindness if untreated

Question 9

newborn risks with gonorrhea

Answer 9

• ophthalmia neonatorium
  
  • subsequent blindness if untreated

Question 10

newborn risks with syphilis

Answer 10

• congenital syphilis

Question 11

newborn risks with HSV type 2

Answer 11

• primary infection esp in 3rd trimester can cause IUGR or prematurity

Question 12

newborn risks with CMV

Answer 12

• will be symptomatic at birth
• LBW
• IUGR
• infected newborn may shed the virus from the nasopharynx and urine for several years after birth
  
  • these are a reservoir of infection for uninfected caregivers

Question 13

newborn risks with Hep B

Answer 13

• LBW
• infants can be chronic carriers

Question 14

newborn risks with HIV

Answer 14

• signs appear at 4-12 mos
  
  • infected infant develops failure to thrive, hepatospenomegaly, SGA, epstein barr virus
  • mortality
  • pneumonia, recurrent infections, neuro abnormalities
  • persistent Candida or bacterial infections

Question 15

newborn risk with Candidiasis

Answer 15

• oral thrush

Question 16

newborn risks with GBS

Answer 16

• can be early or late onset
• sudden onset of respiratory distress
• temp instability in newborn

Question 17

newborn risks with rubella

Answer 17

• abortion
• IUGR
• if born to mother with rubella, shed virus for many months
  
  • pose a threat to other infants and susceptible adults who come in contact w/ them

Question 18

newborn risks with toxoplasmosis

Answer 18

• prematurity
• stillbirth
• neonatal death
• congenital anomalies

Question 19

newborn risks with Condyloma acuminatum (Venereal Warts)

Answer 19

• laryngeal papilloma