Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, Maryland, USA.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Dev Med Child Neurol. 2021 Feb;63(2):135-143. doi: 10.1111/dmcn.14682. Epub 2020 Oct 21.
Prenatal infections have long been recognized as important, preventable causes of developmental disabilities. The list of pathogens that are recognized to have deleterious effects on fetal brain development continues to grow, most recently with the association between Zika virus (ZIKV) and microcephaly. To answer clinical questions in real time about the impact of a novel infection on developmental disabilities, an historical framework is key. The lessons learned from three historically important pathogens: rubella, cytomegalovirus, and ZIKV, and how these lessons are useful to approach emerging congenital infections are discussed in this review. Congenital infections are preventable causes of developmental disabilities and several public health approaches may be used to prevent prenatal infection. When they cannot be prevented, the sequelae of prenatal infection may be treatable. WHAT THIS PAPER ADDS: The list of prenatal infections associated with developmental disabilities continues to increase. Lessons learned from rubella, cytomegalovirus, and Zika virus have implications for new pathogens. Severity of illness in the mother does not correlate with severity of sequelae in the infant.
产前感染一直被认为是导致发育障碍的重要、可预防的原因。已知会对胎儿大脑发育产生有害影响的病原体清单不断增加，最近与寨卡病毒 (ZIKV) 和小头畸形之间的关联就是一个例证。为了实时回答有关新感染对发育障碍影响的临床问题，历史框架是关键。本文讨论了从三种具有重要历史意义的病原体（风疹、巨细胞病毒和 ZIKV）中吸取的经验教训，以及这些经验教训如何有助于应对新出现的先天性感染。先天性感染是导致发育障碍的可预防原因，可采用多种公共卫生方法来预防产前感染。当无法预防时，产前感染的后遗症可能是可治疗的。本文的新增内容：与发育障碍相关的产前感染清单不断增加。从风疹、巨细胞病毒和寨卡病毒中吸取的经验教训对新病原体具有启示意义。母亲的疾病严重程度与婴儿的后遗症严重程度不相关。
