Tremolada S, Delbue S, Ferrante P
Center for Translational Research and Laboratory of Pathology, Saint Joseph Hospital, MilanoCuore, Milano.
Pediatr Med Chir. 2008 Jul-Aug;30(4):177-91.
Viral infections may be vertically transmitted from mother to child at different times, ranging from in utero transmission, which occurs during pregnancy, perinatal transmission, which takes place during delivery and postnatal transmission, which is usually the consequence of breastfeeding. Mother-to-child transmission, which may occur after primary, recurrent or chronic maternal infection, is potentially harmful to the fetus or the newborn since it may result in miscarriage, fetal death, congenital anomalies, intrauterine growth restriction, or severe neonatal disease. Some risk factors are thought to affect the rate of mother-to-child transmission, such as the presence of other viral infections, maternal viral load, type of infection (primary versus recurrent), obstetrical procedures (prolonged rupture of membranes, mode of delivery), social-economical conditions and breastfeeding. For some of the vertically transmitted viruses, interventions are nowadays available to prevent mother-to-child transmission, such as vaccines, passive immunization, antiviral drugs. Moreover, perinatal and postnatal infections may be prevented by the use of elective caesarean delivery and avoidance of breastfeeding.
病毒感染可能在不同时期由母亲垂直传播给孩子,范围从孕期发生的宫内传播、分娩时发生的围产期传播,到通常由母乳喂养导致的产后传播。母婴传播可能发生在母亲初次、复发或慢性感染之后,对胎儿或新生儿有潜在危害,因为它可能导致流产、胎儿死亡、先天性畸形、宫内生长受限或严重的新生儿疾病。一些危险因素被认为会影响母婴传播率,如其他病毒感染的存在、母亲病毒载量、感染类型(初次感染与复发感染)、产科操作(胎膜早破时间延长、分娩方式)、社会经济状况和母乳喂养。对于一些垂直传播的病毒,现在有干预措施可预防母婴传播,如疫苗、被动免疫、抗病毒药物。此外,可通过选择性剖宫产和避免母乳喂养来预防围产期和产后感染。