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### **Immunization Schedule** - Started at 6 months of age - Premature infants: started when the infant weighs 2 kg or is 2 months old #### **HBV Positive Mother** - Infant should be bathed carefully, wearing gloves, to remove all maternal blood and body fluids - Infant should receive an IM injecti...

### **Immunization Schedule** - Started at 6 months of age - Premature infants: started when the infant weighs 2 kg or is 2 months old #### **HBV Positive Mother** - Infant should be bathed carefully, wearing gloves, to remove all maternal blood and body fluids - Infant should receive an IM injection of hepatitis B immunoglobulin within 12 hours of birth - This treatment is up to 95% effective in preventing the development of the disease in the infant - Hepatitis C is rarely transmitted to the fetus - The greatest risk is Hepatitis E, with a mortality rate of about 20% during pregnancy ### **Enteroviruses** - Include coxsackievirus, echovirus, and poliovirus - Most infections (90%) are asymptomatic in adults - Most researchers believe neonatal infections are acquired perineally but that infection occurs during delivery or after birth (≤2 weeks) from exposure to a mother with the virus or another infected infant - Neonates are at increased risk of developing sepsis-like conditions - May be difficult to differentiate enterovirus infection from bacterial sepsis - Neonates < 10 days are at increased risk from non-polio enteroviruses - Neonates may be lethargic, feverish and exhibit signs of hypoperfusion (mottled skin, delay in capillary refill time, and cyanosis) and jaundice - Neonates often feed poorly and cry inconsolably ### **Toxoplasmosis** - Protozoal infection with *Toxoplasma gondii* - Affects about 38% of pregnant women - About 1 in 1000 pregnant women become infected during pregnancy - Primary transmission occurs from ingesting undercooked meat or unpasteurized goat's milk, or contacting infected cat feces - Risk to the fetus is greatest if the disease occurs during the first trimester - Often causes severe fetal abnormalities, such as microcephaly or hydrocephalus, or miscarriage - However, risk of fetal transmission is greatest during the 3rd trimester, although 70% are born without indications of infection - Mild infection may be manifest by retinochoroiditis at birth (with other symptoms delayed) - Severe infection may result in convulsions and coma from CNS abnormalities - Other abnormalities include hepatomegaly, splenomegaly, anemia, jaundice, and deafness - Maternal treatment to reduce risk of transmission to the fetus includes: - Spirymycin (Rovamycine®) initially - Pyrimethamine (Daraprim®) and sulfonamide after the 18th week - Some studies indicate treatment does not reduce the rate of mother-infant transmission but reduces the severity of abnormalities ### **Group B Streptococcus (GBS)** - Most common neonatal bacterial infection - Many women are asymptomatic carriers - Screening of all pregnant women around 36 weeks of gestation followed by antibiotic treatment of the mother during labor can prevent neonatal infection - A mother needs at least 4 hours worth of antibiotic treatment for the infant to benefit - Infant will often be treated with IV ampicillin and gentamicin for 10 to 14 days if the mother has not received the recommended treatment - An infant with a GBS infection that manifests in the first 24 hours after birth may develop pneumonia and/or meningitis, respiratory distress, floppiness, poor feeding, tachycardia, shock and seizures - Late-onset infections (usually meningitis) are generally more serious than earlier onset and survivors often have serious damage ### **Other Conditions** - Intellectual disability - Hydrocephalus - Guillain-Barré syndrome - Rubella - Neonatal sepsis