The unborn fetus is generally able to tolerate infections in the mother without complication. When the mother has a cold or the flu, it is unknown in the fetus also feels sick.  Nonetheless, minor illness in the mother has little or no effect on the fetus. Some specific illnesses, however, may be serious and the unborn fetus even when the mother has few or no symptoms.  The so-called  "TORCH" infections are particularly concerning for the unborn infant. TORCH Is an acronym for T - toxoplasmosis, O - other, R - rubella (also known as German measles), C - cytomegalovirus, H - herpes simplex virus.  The O - other category includes: hepatitis B and C, HIV, parvovirus B19, syphilis, and varicella-zoster virus (the chicken pox virus).  If acquired during pregnancy by the mother, these infections can have severe consequences on a newborn infant.

What happens if I get sick during pregnancy? 

Typical mild illnesses in a pregnant mother rarely have consequences in the unborn infant.  Nonetheless, a pregnant mother should do her best to avoid illness and to treat illness appropriately. Some over the counter medications may be dangerous for the unborn infant, therefore the use of all medications should be discussed with a physician. A pregnant mother should avoid dehydration and should get adequate rest during an illness.  In most cases it is best to discuss illness during pregnancy with your physician.

What are the "TORCH" infections? 

The TORCH Infections are a group of illnesses that may have a minor or no symptoms in the pregnant mother while causing significant problems in a fetus.  TORCH Is an acronym for T - toxoplasmosis, O - other, R - rubella (also known as German measles), C - cytomegalovirus, H - herpes simplex virus.  The O - other category includes: hepatitis B and C, HIV, parvovirus B19, syphilis, and varicella-zoster virus (the chicken pox virus).  The TORCH infections are discussed below.

Toxoplasmosis 

Toxoplasmosis is caused by a parasite that commonly affects household cats.   It may also be found in undercooked meat and fish.  Cats acquire toxoplasmosis infection by feeding on other infected animals such as rodents or uncooked meats. Once infected, Toxoplasma gondii eggs are secreted in the cat's stool for up to 2 weeks .  Pregnant females should avoid contact with cat litter boxes and other sources of cat feces as much as possible.

Toxoplasmosis infection in an adult or older child typically causes few or no symptoms and resolves without treatment.  If present, symptoms may include a general sick feeling, fever, sore throat, muscle aches, and swollen lymph nodes. Unfortunately, infants born to mothers who had toxoplasmosis infection during pregnancy may develop the congenital form of toxoplasmosis infection.

Infants with congenital infection have no symptoms inup to 90% of cases.  However, symptoms will become apparent in many of these children later in childhood.  These include: vision problems, learning disabilities, and mental retardation.  Some severely infected infants may develop severe brain abnormalities, deafness, seizures, and vision impairment.  Others die before birth or shortly thereafter. 

Treatment - The best "treatment" is to avoid infection in the first place.  If congenital infection develops, infants may be treated with anti-parasite medications for a year or longer.

Precautions - Pregnant females should:

• Avoid cleaning cat litter boxes.
• If absolutely necessary to clean litter boxes, the woman should use gloves and wash her hands thoroughly afterwards.
• Wash vegetables well.
• Avoid contact with raw meat, or wash hands thoroughly afterwards.
• Cook meat thoroughly.
• Clean all surfaces that have come in contact with raw meat or unclean vegetables. 

Hepatitis B

Hepatitis B can be passed from mother to her child at birth.  It is unknown if the infection can be transmitted to the unborn fetus through the placenta but this risk seems to be low.  Pregnant mothers without hepatitis B should receive immunization to hepatitis B prior to delivery of the infant.  Vaccination during pregnancy poses no known risk to the unborn infant.  If the mother is known to have hepatitis B, treatment prior to and at the time of delivery can reduce the risk of transmission of the illness to the infant.  Infants born to mothers with hepatitis B should receive a hepatitis B vaccination (currently recommended within the first 12 hours of life) and hepatitis B immunoglobulin.  Infants who develop hepatitis B infection around the time of birth are at high risk for developing a chronic infection.  Chronic hepatitis B in a child may lead to liver failure and/or liver cancer at an early age.

Breastfeeding is not known to increase the risk of transmission of hepatitis B from the mother to the infant.

Hepatitis C

Hepatitis C can be passed from an infected mother to her infant at delivery.  This risk is likely around 5% and may be less when the mother's infection is treated during pregnancy.  Hepatitis C causes a chronic infection in infants that slowly damages the liver.  Infants and children are unlikely to have any symptoms from hepatitis C infection.  The major risk of infection is chronic liver damage leading to liver failure or liver cancer later in adulthood.

Human immunodeficiency virus (HIV)

A pregnant mother with HIV may infect her child during pregnancy, during the delivery, or by breastfeeding after birth.  Aggressive treatment of the pregnant mother with HIV and preventative treatment of the infant are recommended.  HIV infection in an infant can cause severe disease later in childhood. HIV infected mothers are more likely to pass other illnesses (i.e., hepatitis B & C) to their infants also.

Parvovirus B19

Parvovirus B19 infection is common in children and adults.  Most people have been infected with this virus by late adulthood.  Typical parvovirus B19 infections cause a brief illness with: fever, cough, muscle aches, joint pains and a headache.  A characteristic rash appears about 1 week after these symptoms resolve.  In children the rash begins with redness on the cheeks sometimes called a "slapped cheek" rash and also a lace-like pink rash over the body, arms and legs.  The symptoms resolve without treatment. 

Parvovirus B19 causes a temporary decrease in red blood cell production.  For most healthy people this causes no problems.  If a child already has a disease affecting the red blood cells (i.e., sickle cell anemia), the child may become severely anemic.

Parvovirus B19 infection in a pregnant female may lead to fetal death in up to 6% of cases.  The greatest risk appears to occur when the mother acquires the illness in the first half of the pregnancy.

Syphilis

Syphilis in a pregnant female may cause severe problems in the unborn infant.  Infected infants may have: brain damage, skin rash, bone inflammation, anemia, deafness, blindness and blood clotting abnormalities. Some symptoms may not become apparent for several years.  Syphilis should be treated aggressively in infected mothers and infants.

Varicella-zoster virus (VZV)

VZV is the chicken pox virus.  Chicken pox is now uncommon in countries where children are vaccinated early in life.  Adults may have a reactivation of VZV, causing shingles.  Mothers who develop the first VZV infection during pregnancy (especially early in pregnancy) may transmit the virus to the fetus.  Fetal infection may result in death of the fetus, arm and leg abnormalities, skin scarring, eye damage, and brain damage.  At the time that this article was written, vaccination during pregnancy was not recommended since the vaccine may cause fetal infection.

Rubella (a.k.a., German measles)

Rubella infection is rare in the United States now that all children are routinely vaccinated.  Most pregnant females are "rubella immune," which means the vaccine was successful.  Rubella can be transmitted from a pregnant female to the fetus.  The most common symptoms of rubella infection in a newborn are: cataracts (cloudiness of the clear part of the eye, decreasing vision), heart defects, hearing loss, brain damage, pneumonia, bone disease, skin rash, and other defects.

Cytomegalovirus (CMV)

CMV is a virus that affects almost everyone early in childhood.  Most infections in children have no symptoms.  If symptoms are present, they often mimic the "common cold" with: fever, cough, muscle aches, headache, sore throat, etc.  Once infected with a particular strain of CMV, the virus stays in the body without causing symptoms.  The immune system typically prevents the virus from causing symptoms again.  There are many strains of this virus and therefore a person may be infected with CMV more than once.

If a pregnant mother becomes infected with a strain of CMV for the first time, it is possible to pass the virus to the unborn infant.  Because the virus is so common, about 1% of all infants are born with CMV infection.  However, only about 10% of these infants have symptoms.  The most common symptom is hearing loss.  Other symptoms include: small size, rash, jaundice, vision loss, and brain damage.

 Herpes simplex virus (HSV)

HSV comes in two major forms: HSV-1 (the "cold sore virus") and HSV-2 (the sexually-transmitted disease "herpes").  Both types of HSV can infect the infant at birth.  Treatment of HSV prior to and during birth can prevent infection in an infant.  An infected infant may develop life-threatening disease.  The characteristic lesions may be visible on the infant's skin and help with the diagnosis when present.  Infected infants may develop liver, lung, and brain damage.

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