Biological agents and pregnancy.

Pregnant women are exposed to many biological, eg microbial, agents, which are potentially harmful to the fetus. The reported rates of vertical transmission of hepatitis B and human immunodeficiency virus vary between 3 to 90% and 0 to 65%, respectively. The susceptibility to hepatitis B and human immunodeficiency infection is increased in pregnant physicians, midwives, and nurses because of the bloodborne nature of these viruses. Also, TORCH (toxoplasmosis-rubella-cytomegalovirus-herpes) infections, acquired during pregnancy, may result in congenital infection, and serious sequelae in the neonatal period or years after birth. Schoolteachers and daycare personnel have an increased risk of perinatal varicella, "fifth disease," and mumps. Perinatal listeriosis affects one in 20,000 births and may result in fetal wastage. Because of the risk of the possibility of vertical transmission, immunization during pregnancy with live virus vaccines is not recommended.