Bitnun Ari, Sauvé Laura, Fanella Sergio
Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario, Canada.
Paediatr Child Health. 2023 Jul 22;28(5):307-323. doi: 10.1093/pch/pxad014. eCollection 2023 Aug.
Inadequate prenatal care increases risk for maternal infections going undetected and untreated, putting both the mother's health and that of her infant at risk. When pregnant women present late to care, routine testing that impacts infant management should include: hepatitis B surface antigen (HBsAg); serology for hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis; and testing for and . If the mother was not tested before or after delivery and is not available for testing, the infant should undergo testing for HIV, HBV, HCV, and syphilis. Testing for and should be undertaken if the infant develops compatible clinical manifestations. Rapid turnaround of test results for HIV, HBV, and syphilis is optimal because preventive treatment decisions are time-sensitive. Early and effective preventive interventions are available for newborns at risk for HIV, HBV, syphilis, or gonorrhea. Close clinical follow-up and follow-up testing of infants born to mothers with inadequate prenatal care are warranted, as not all infections can be fully excluded perinatally.
产前护理不足会增加孕产妇感染未被发现和治疗的风险，危及母亲及其婴儿的健康。孕妇就诊过晚时，影响婴儿管理的常规检测应包括：乙肝表面抗原（HBsAg）；丙型肝炎病毒（HCV）、人类免疫缺陷病毒（HIV）和梅毒的血清学检测；以及检测 和 。如果母亲在分娩前或分娩后未接受检测且无法进行检测，婴儿应接受HIV、HBV、HCV和梅毒检测。如果婴儿出现相关临床表现，应进行 和 的检测。HIV、HBV和梅毒检测结果的快速周转是最佳的，因为预防性治疗决策对时间敏感。对于有感染HIV、HBV、梅毒或淋病风险的新生儿，可进行早期有效的预防性干预。对于产前护理不足的母亲所生的婴儿，有必要进行密切的临床随访和后续检测，因为并非所有感染都能在围产期完全排除。
