Infectious diseases are disorders caused by pathogenic microorganisms (e.g., bacteria, viruses, fungi, parasites) that may be transmitted directly or indirectly by various sources (e.g., person to person, insects, animals, environment, food, water). Some infections may be harmful, but some may be harmless; all may be preventable. Certain patient populations, including pregnant women, may also be more susceptible to infections

During pregnancy, some common infections that may occur are influenza, vaginal yeast infections, eczema, herpes, uterine infections, group B streptococcus (GBS), bacterial vaginosis (BV), and listeria. Changes in immune function, such as reduction in T- and B-cell activity and natural killer–cell activity and increases in dendritic-cell activity, may cause this increased risk of infection.2,3 However, immune-system changes during pregnancy are not fully understood, and more data are needed.

The severity of some infections, such as influenza, GBS, sexually transmitted diseases, urinary tract infections, and Zika virus, may also increase with advancing pregnancy.4 Complications from severe infections during pregnancy may include preterm birth, low birth weight, birth defects, learning problems, and possibly pregnancy loss.5-7 Prevention, early detection, and treatment are vital to help minimize and eliminate these complications with multiple available prevention and treatment strategies. The problem lies with growing and novel pathogens, as data are limited to devise a response plan to emerging infections such as the current pandemic.

VIRAL VERSUS BACTERIAL

Many viral infections during pregnancy are considered benign; but due to the immunological changes that are associated with pregnancy, the severity of viral infections may increase.9 In addition, there is little available information about how pregnancy affects the mother’s response to viral pathogens; however, it is thought that placental response to viruses may play a role in the severity of infection.6,9 When pandemics such as influenza, Ebola, Zika, and COVID-19 occur, it becomes challenging to prevent and treat these infections with the complexity and uncertainty of immunological changes during pregnancy.

Viruses and infections associated with pregnancy include herpes simplex virus (HSV); varicella zoster virus (also known as chickenpox); cytomegalovirus; rubella; human immunodeficiency virus (HIV); hepatitis; influenza; and Ebola.

Bacterial infections may also affect women throughout their pregnancy term and the fetus and newborn. Like viral infections, it is just as important to screen, treat, and prevent these infections to decrease complications with pregnancy.10 Bacteria and infections associated with pregnancy include GBS; urinary tract infections; listeriosis; syphilis; chlamydia; and bacterial vaginosis.