Reducing Prenatal Infection Risk Reduces Sepsis Risk

Expectant parents have enough to worry about as they wait for their baby to arrive – prenatal infections shouldn’t be among them. A prenatal infection is an infection that occurs during pregnancy. According to the National Association of County and City Health Officials, based in Washington, DC, “Due to the serious consequences for mother and baby, prenatal infection prevention is a critical component of the broader maternal and child health strategy to ensure that mothers and babies “survive and thrive.”” February is International Prenatal Infection Prevention Month and Sepsis Alliance is raising awareness of how prenatal infections can lead to sepsis.

Infections During Pregnancy

Anyone can develop an infection at any time, even during pregnancy.

Common Infections:

Many infections don’t usually affect the pregnancy or the growing fetus, such as:

• Uncomplicated cellulitis
• A cold
• An infected hangnail or other minor wounds

However, it is still essential to monitor these common infections to ensure they don’t worsen or cause sepsis.

More Dangerous Infections During Pregnancy

Other infections, like bacterial group B strep or urinary tract infections (UTIs), or viral Zika or hepatitis, can have devastating consequences for an unborn child. Some infections, such as HIV, can be passed on to the baby if the parent is not receiving treatment for the disease. With HIV, for example, the risk for the baby contracting the infection is about 25% without treatment, but it drops dramatically to less than 1% with treatment.

Along with group B strep, UTIs, Zika, HIV, and hepatitis, some other common infections that could cause harm or severe illness to the baby include:

• Sexually transmitted infections, including chlamydia and genital herpes
• Bacterial vaginosis
• Toxoplasmosis
• Yeast infections
• Cytomegalovirus (CMV)
• Fifth disease (a common childhood disease)
• Listeria or listeriosis, a type of food poisoning
• Rubella (German measles)
• Trichomoniasis
• COVID-19
• Influenza

Preventing Prenatal Infections

The best time to start prenatal infection prevention is before pregnancy. If you are planning to get pregnant, speak with your healthcare provider about what vaccinations you should have, including those for childhood diseases and newer ones like COVID-19. Having a weakened immune system, either because of illness, medications, or some other reason, such as not having a spleen, is a risk factor for infection. Speak with your doctors about what precautions you should take before and after you become pregnant.

If you are pregnant already, it’s not too late to reduce your risk of prenatal infections:

• Stay away from areas that have the Zika virus. If you must be in a place where Zika is present, speak with your doctor about what products you can use to avoid mosquito bites. If your partner has returned from an area that has Zika, avoid sex or use condoms during sexual activity to prevent contracting the virus during your pregnancy.
• Attend regularly scheduled prenatal health and wellness appointments
• Be tested for sexually transmitted infections
• Be tested at around 36 weeks of pregnancy for group B strep infection
• Get vaccinated against influenza and COVID-19, and any other infections recommended by your doctor
• Don’t consume raw or undercooked meat, poultry, seafood, eggs, or unpasteurized juice and dairy products. Pregnancy affects the immune system and can make it easier to contract some foodborne illnesses.
• Wash your hands regularly and thoroughly, including after:
  • Touching raw meat, poultry, fish, or eggs, as well as unwashed vegetables
  • Gardening
  • Being out and about, shopping, etc.
  • Changing diapers or cleaning someone who has been incontinent
  • Touching animals, including pets
• If you have a cat, designate someone else to change the litter. Wear gloves and wash your hands immediately after if you absolutely must do so.
• Avoid people who are sick. Wear a mask and wash your hands thoroughly after contact if you must be in contact.

Treating Prenatal Infections

Treating prenatal infections is not all that different from infections at any other time.  However healthcare professionals must use caution in what medications they prescribe. Some antimicrobials (medicines that fight infections) are safe during pregnancy for both the parent and baby, but some must be avoided.

Speak with your doctor about the medications and any concerns you may have.

Prenatal Infection Prevention Is Sepsis Prevention

The only way to prevent sepsis, the body’s life-threatening inflammatory response to an infection, is to prevent infection in the first place. Ask your healthcare provider who you should contact, regardless of the time of day, if you believe you may have an infection. Some providers will want their patients to contact them or a practice group member directly, while others may direct you to a local clinic or emergency department.

Diagnosing and treating sepsis during pregnancy can be challenging. It can be harder to recognize the signs because they could mimic those from pregnancy. These include symptoms like a higher-than-normal body temperature or rapid heartbeat. UTIs may go unnoticed because increased urination is common during pregnancy. Even diagnosing pneumonia can be challenging, given that the lungs may be compressed by the enlarged uterus, making it harder to see the lungs clearly. Treatment is also a challenge. According to a study published in 2019, an infection can cause a more rapid deterioration during pregnancy and immediately after delivery than in a non-pregnant person.

If you have an infection, watch for signs of sepsis, even if you take medications to treat the infection. If you have any sepsis signs, this is a medical emergency. Be sure to tell the emergency personnel, including 911 operators, that you are pregnant and you suspect sepsis.