Antenatal screening in Europe: How to avoid mother-to-child transmission of infections

This picture exhibits transmission of infections with HIV, hepatitis B, syphilis or rubella from mom to baby earlier than and through delivery in addition to in infancy nonetheless happen throughout Europe.
Credit score: ECDC
Transmission of infections with HIV, hepatitis B, syphilis or rubella from mom to baby earlier than and through delivery in addition to in infancy nonetheless happen throughout Europe -- regardless of present prevention strategies. A brand new ECDC report outlines the cornerstones for efficient antenatal screening programmes throughout the EU/EEA international locations.
Annually, greater than 5 million dwell births are recorded within the European Union. Nearly as many pregnant ladies are screened for infections -- particularly for HIV, syphilis, hepatitis B and rubella susceptibility -- with a view to stop potential mother-to-child transmission (MTCT).
Nevertheless, youngsters are nonetheless being born with these infections within the EU/EEA. For instance, 424 congenital syphilis infections and 274 HIV infections have been reported in youngsters born between 2010 and 2014.
In its evidence-based steerage, ECDC goals to assist Member States to strengthen antenatal screening within the basic inhabitants and specifically amongst weak teams for MTCT.
The steerage seems at which parts of a nationwide antenatal screening programme for infections affect effectiveness, and that are the particular approaches for use for reaching the weak teams with a view to improve the uptake of prenatal care and scale back mother-to-child transmission. The steerage is accompanied by two technical studies of literature critiques.
Among the many foremost proposals for efficient antenatal screening are:
  • Testing for HIV, syphilis and hepatitis B in the course of the first trimester of being pregnant.
  • Repeat testing provide in the course of the third trimester for pregnant ladies at elevated threat of an infection and/or for many who beforehand refused testing.
  • Testing at supply to ladies who had not beforehand been examined.
  • For HIV and syphilis specifically, a common method ought to be thought-about for the antenatal screening, which suggests voluntary testing for all pregnant ladies with an opt-out chance.
To enhance the uptake of antenatal testing amongst weak teams like migrant ladies or ladies at increased threat for infections because of injecting drug use or these partaking in excessive threat sexual practices, a number of choices could also be thought-about.
This consists of addressing communication limitations relating to language, literacy ranges, or particular person or cultural specifics, and bettering entry to antenatal care by means of outreach companies and casual networks may help.
Why check for infections throughout being pregnant?
Mom-to-child transmission is essentially the most predominant mode of HIV an infection in younger youngsters worldwide. With out intervention, the danger of HIV transmission from an contaminated mom to her baby ranges from 15% to 30% throughout being pregnant/supply to between 10% and 20% throughout breastfeeding. This threat will be lowered to 1 to 2% with a mixture of applicable antenatal interventions together with antiretroviral remedy (ART) for the mom, antiretroviral prophylaxis for the new child, and avoidance of breastfeeding.
Transmission of hepatitis B from mom to baby is preventable in 95% of all instances by means of the administration of vaccine and immunoglobulin to the infant at delivery. With no immunoprophylaxis, greater than 90% of infants contaminated by their constructive moms will go on to develop continual an infection.
There isn't any remedy for rubella however MTCT will be prevented by making certain that each one ladies who plan to get pregnant are immune or have been immunised in opposition to rubella.


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