Pregnant women are generally more susceptible to certain infections compared to those who are not pregnant. This is because the body goes through a series of hormonal changes and alterations in immune function during pregnancy, which can elevate the risk of infections. For instance, the added pressure on the bladder and the changes in immune response make pregnant women more prone to urinary tract infections (UTIs). Any infection that occurs during pregnancy is referred to as an infection in pregnancy.
There are four stages of infections in pregnancy: (based on period of infection)
- Periconceptual Infection: An infection that occurs around the time of foetal conception.
- First Trimester Infection: An infection that occurs from the last menstrual period up to 13 weeks of gestation.
- Second Trimester Infection: An infection that occurs between 14 and 27 weeks of gestation.
- Third Trimester Infection: An infection that occurs between 28 weeks of gestation and delivery.
This article examines some common infections during pregnancy and explores strategies for their prevention.
Types of Infections Common During Pregnancy
Some infections can be harmful to both mother and baby, while others may not cause serious problems. However, most of these infections can be prevented with a combination of proactive practices and appropriate precautions. Below are some common infections that can occur during pregnancy.
Urinary Tract Infections (UTIs)
A urinary tract infection affects the urinary system, which includes the kidneys, bladder, ureters and urethra. It is caused by bacteria entering the urinary tract, leading to an infection. Women have a 1 in 10 chance¹ of getting a urinary tract infection during pregnancy. This condition can increase the risk of preterm labour and low birth weight² and a higher incidence of foetal loss early in pregnancy, and, if left untreated, may even contribute to renal disease for the mother.
Bacterial Vaginosis (BV)
Bacterial vaginosis is an infection of the vagina that arises from an imbalance of the vaginal microbiome. It is commonly caused by douching, engaging in unprotected sex, and having multiple sexual partners. The most prominent sign of having bacterial vaginosis is discharge with a fishy odour. As with other bacterial infections of the vagina, BV can lead to complications like premature birth and low birth weight³. It can also increase the risk of contracting sexually transmitted infections (STIs).
Group B Streptococcus (GBS)
Group B streptococcus, more simply known as group B strep, is a bacterial infection that’s usually characterised as asymptomatic and harmless, including in pregnant women. However, it can be serious for newborns who acquire the infection from their mothers, potentially resulting in septicaemia (blood infection), pneumonia (lung infection) and meningitis (infection and inflammation of the membranes surrounding the brain and spinal cord)⁴. Testing for group B strep in the third trimester can help prevent a dangerous GBS infection. Antibiotics prophylaxis given around time of delivery can prevent transmission of bacteria from mother to baby.
Cytomegalovirus (CMV)
Cytomegalovirus is also a common virus that can infect people of all ages. Once CMV enters the body, it remains there for life, with over half of adults being infected by age 40⁵. However, CMV becomes a problem when women develop an active infection during pregnancy. If the infection is passed to an unborn baby, it is referred to as congenital CMV. A newborn getting infected during or after birth is called perinatal CMV. Babies with congenital CMV may experience birth defects and developmental delays⁶. Congenital CMV is a cause of neonatal deafness and mental retardation.
Flu and Other Viral Infections
Influenza, or the flu, tends to be more severe for pregnant people than for others. Although the illness is not directly linked to birth defects, it can lead to complications that require hospitalisation and may elevate the risk of birth defects due to high fever, such as spina bifida⁷. Pregnancy increases susceptibility to this common respiratory illness because of the changes in the immune system. Studies reveal that flu vaccines can reduce the likelihood of flu infection in pregnant women by up to 50%⁸. Pregnant women are advised to receive influenza vaccination from the second trimester onwards.
Preventive Measures
To lower the risk of infections, pregnant women can take preventive steps by getting screened for these diseases and adopting simple lifestyle changes to reduce transmission.
Exercising Personal Hygiene
Practising good personal hygiene, such as washing your hands with soap and water after using the toilet, can help prevent infections like cytomegalovirus. Additionally, wiping from front to back can contribute to a decreased risk of urinary tract infections. These careful and healthy habits can stop the spread of germs and protect you from a range of infections.
Maintaining a Balanced Diet
You can support your immune system by giving your body the nutrition it needs. This includes getting enough nutrients from a variety of foods from all the main food groups. Key nutrients for a healthy immune system include vitamin C, vitamin D, zinc, selenium, iron, and protein, according to The Nutrition Source⁹ from the Harvard T.H. Chan School of Public Health.
Regular Medical Check-Ups
Routine screenings and tests are part and parcel of pregnancy for a reason. Distributed across the first, second and third trimesters, these tests help to determine any infections or other health issues that could pose a danger to you and your baby. Early detection of these infections allows for timely treatment and management, reducing the risk of complications and ensuring better outcomes for mother and child. Maternal screening for HIV and Hepatitis B are routine as interventions are available to prevent transmission to newborns.
Practising Safe Sex
The severity of sexually transmitted infections are said to increase as pregnancy progresses¹⁰. Therefore, using condoms to eliminate direct skin contact with infected body secretions can help decrease the risk of these infections for pregnant women and consequently, their babies. Protection is also beneficial for preventing other diseases in pregnancy, such as bacterial vaginosis and hepatitis.
Staying Up to Date on Vaccinations
Certain vaccines are considered safe and even recommended for pregnant women, such as the flu vaccine and Tdap vaccine¹¹, which protects against diphtheria, tetanus, and pertussis. However, some vaccines are not advised during pregnancy because they contain live viruses, which could potentially be damaging to the health of the foetus. Recently RSV vaccines have been added to the list.
Seek Medical Attention When Necessary
While many infections during pregnancy may not lead to complications, it’s crucial to consult a doctor if you have any concerns or experience unusual symptoms. Don’t leave infections undetected or untreated. By staying vigilant and seeking prompt treatment, you can help ensure a healthy pregnancy and a safe birth.
For more information on infections during pregnancy, visit our page here.
References
- Urinary tract infections (UTIs) during pregnancy. Pregnancy, Birth and Baby. https://www.pregnancybirthbaby.org.au/urinary-tract-infections-utis-during-pregnancy. Accessed July 30, 2024.
- What if I Get a Urinary Tract Infection (UTI) While I’m Pregnant? WebMD. https://www.webmd.com/women/pregnancy-urinary-tract-infection. Accessed July 30, 2024.
- About Bacterial Vaginosis (BV). Bacterial Vaginosis (BV). Centers for Disease Control and Prevention. https://www.cdc.gov/bacterial-vaginosis/about/index.html. Accessed July 30, 2024.
- Group B Streptococcus. SingHealth. https://www.singhealth.com.sg/patient-care/conditions-treatments/Group_B_Streptococcus. Accessed July 30, 2024.
- About Cytomegalovirus. Cytomegalovirus (CMV) and Congenital CMV Infection. Centers for Disease Control and Prevention. https://www.cdc.gov/cytomegalovirus/about/index.html. Accessed July 30, 2024.
- Cytomegalovirus (CMV) infection. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358. Accessed July 30, 2024.
- Flu & Fever During Pregnancy: Complications and Treatment. HealthXchange. https://www.healthxchange.sg/women/pregnancy/flu-fever-pregnancy-complications-treatment. Accessed July 30, 2024.
- Flu During Pregnancy: Symptoms, Risks & Prevention. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23104-flu-while-pregnant. Accessed July 30, 2024.
- Harvard T.H. Chan School of Public Health. Nutrition and Immunity. The Nutrition Source. https://nutritionsource.hsph.harvard.edu/nutrition-and-immunity/. Accessed July 30, 2024.
- Ledan S. Infectious Diseases in Pregnancy. US Pharmacist. https://www.uspharmacist.com/article/infectious-diseases-in-pregnancy. Accessed July 30, 2024.
- Questions about Vaccines during Pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccinesafety/concerns/vaccines-during-pregnancy.html. Accessed July 30, 2024.