Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States; NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, United States.
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Handb Clin Neurol. 2020;172:79-104. doi: 10.1016/B978-0-444-64240-0.00005-2.
Neurologic infections during pregnancy represent a significant cause of maternal and fetal morbidity and mortality. Immunologic alterations during pregnancy increase the susceptibility of the premature brain to damage. This chapter summarizes the epidemiology, pathophysiology, and clinical manifestations in the pregnant woman and the infant, and the diagnosis, treatment, and prevention of the major viral, parasitic, and bacterial infections known to affect pregnancy. These organisms include herpes virus, parvovirus, cytomegalovirus, varicella, rubella, Zika virus, toxoplasmosis, malaria, group B streptococcus, listeriosis, syphilis, and tuberculosis. There is an emphasis on the important differences in diagnosis, treatment, and fetal outcome between trimesters. An additional overview is provided on the spectrum of neurologic sequelae of an affected infant, which ranges from developmental delay to hydrocephalus and seizures.
妊娠期神经系统感染是导致母婴发病率和死亡率升高的重要原因。妊娠期免疫改变会增加早产儿大脑受损的易感性。本章总结了孕妇和婴儿中主要病毒、寄生虫和细菌感染的流行病学、发病机制和临床表现，以及这些已知影响妊娠的病原体感染的诊断、治疗和预防方法。这些病原体包括疱疹病毒、细小病毒、巨细胞病毒、水痘、风疹、寨卡病毒、弓形虫病、疟疾、B 组链球菌、李斯特菌病、梅毒和结核病。本章重点介绍了不同孕期在诊断、治疗和胎儿结局方面的重要差异。此外，还概述了受感染婴儿的一系列神经后遗症，包括发育迟缓、脑积水和癫痫等。
