5. Congenital Infectious Syndromes

This section presents common congenital infectious conditions during pregnancy that contribute to the burden of birth defects, stillbirths and neonatal deaths, namely, congenital rubella syndrome (CRS), congenital syphilis, congenital cytomegalovirus (cCMV) infection and congenital Zika syndrome (CZS). Vaccination, prompt detection and treatment, and other preventive strategies can reduce the number of adverse pregnancy outcomes (birth defects, miscarriages, stillbirths and neonatal deaths) resulting from congenital infections. Surveillance can assess the national and international burden of maternal infection and adverse outcomes, and formulate strategies to reduce transmission from the mother to the fetus.

This chapter includes information on each congenital infection, including background of the infectious agent, clinical manifestations in the mother and the infant, case definitions, laboratory and radiology needed for diagnosis, photographs, and the relevant ICD-10 codes that could be used for surveillance. The diagnostic methods for congenital infections, including laboratory and imaging, are subject to change and might vary by country. This manual provides general information about these methods, but is not intended to be a comprehensive resource for evaluation of at risk or affected individuals. Each section also includes a checklist of items that need to be done as part of the management of a suspected case with a congenital infectious syndrome.

When infection during pregnancy is clinically suspected, laboratory tests to detect congenital infection might include those for cytomegalovirus, herpes simplex virus, rubella, HIV, toxoplasmosis, syphilis, and Zika virus. Prospective mother-infant linked surveillance coupled with birth defects surveillance can provide a more complete picture of these infections and the outcomes associated with them (33).