BACKGROUND- Pregnancy is associated with a state of relative immunosuppression so that the fetus can escape immunologic rejection by the mother. The immunosuppression of pregnancy increases the risk of acquiring specific infectious diseases and increases the risk that these diseases will disseminate to the central nervous system. REVIEW SUMMARY- The maternal and fetal factors that contribute to the immunosuppression of pregnancy are reviewed. There is an increased risk of central nervous system infection and mortality from coccidioidomycosis and tuberculosis during pregnancy. The impaired cell-mediated immunity involving T-lymphocytes during pregnancy increases the risk of maternal and fetal infection with Listeria monocytogenes. Malaria during pregnancy is associated with a high incidence of maternal mortality and increased rates of abortion, stillbirth, and low birth weight. The clinical presentation of each of these infectious diseases is reviewed, as well as the morbidity and mortality of the infection to the mother and the fetus and the recommended antimicrobial therapy of the infection with consideration of the risk of teratogenicity. The recent information on the reduction in the transmission of the human immunodeficiency virus from mother to infant by the administration of zidovudine during pregnancy is also included. CONCLUSION- Although there is an increased risk of central nervous system infection by certain pathogens during pregnancy, these infections can be effectively managed with delivery of a healthy infant.
ASJC Scopus subject areas
- Clinical Neurology