By Varsha Bhatt-Mehta
“An ounce of prevention is worth a pound of cure.”—Benjamin Franklin
February is touted as National Prenatal Infection Prevention month. Pre- and perinatal infections are responsible for significant maternal and newborn morbidity and mortality including premature birth due to maternal infection. Group B streptococcus (GBS) and many other types of pre- and perinatal infections, if left untreated, are devastating for the mother and the newborn infant, leading to significant maternal and neonatal morbidity and mortality. Such infections can be prevented with healthy pregnancy habits remembered by using the mnemonic “HYGIENE,” which stands for Handwashing, saying Yes to prenatal care, eating Good and safe food, saying yes to Immunizations, Evading others’ bodily fluids, saying No to unnecessary invasive procedures, and taking Environmental precautions to avoid deadly infections such as influenza, malaria, and a group of infections called TORCH, which includes Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes. TORCH infections are some of the most common infections associated with congenital anomalies.
Babies can be infected before, during, or after birth. Nearly every large professional organization worldwide related to maternal and child health has published guidelines for prevention and treatment of maternal and neonatal GBS and other life threatening infections. This information is freely available on the Center for Disease Control and Prevention’s (CDC) website. The international group Group B Strep International is also raising awareness of GBS bacterial infections worldwide. Efforts for universal screening of pregnant women for GBS are ongoing as well. However, the incidence of maternal and newborn mortality secondary to sepsis remains high especially in resource-poor countries where universal GBS screening is not prevalent. A recent report (PDF) suggests that sepsis is still a significant cause of maternal and infant mortality worldwide. Within the U.S., the CDC puts the incidence of GBS at one in four pregnant women. The primary reason for morbidity and mortality is not only lack of awareness but also lack of resources necessary for prevention and treatment of prenatal and perinatal infections and other contributors of maternal and newborn mortality. The report on maternal and child mortality outlines priorities for ending preventable maternal and newborn deaths to which sepsis is a major contributor.
Reducing maternal and newborn mortality requires the help of every health care provider involved directly or indirectly in the care of the unborn or newborn baby or the pregnant mother. Each and every one of us has the responsibility to understand the importance of prevention of infections in pregnant women, educate the public on routine screening available and recommended it for pregnant women during pregnancy, generate resources for resource-poor nations, and support all expectant mothers at every stage of pregnancy to deliver a healthy newborn. A healthy newborn infant is the most valued resource of any nation. As health care providers, we have the responsibility to develop a healthy future generation. Together, we can do it!