Are you a mother-to-be? Or is someone in your family about to have a baby? Then this article will be very important to you. Sometimes, diseases can be passed from mother to baby without you knowing. That's exactly what we're talking about today, mother-to-baby transmission.
What is Vertical Transmission?
Simply put, 'Vertical Transmission' is the transmission of an infection, that is, a disease, from a mother to her baby during pregnancy, during childbirth, or while breastfeeding after the baby is born. The types of germs that can cause this are viruses, bacteria, and parasites. Imagine that you have a minor cold. It may not be a big deal to you. But if you are pregnant, even that minor illness can have a big impact on the baby in the womb. This transmission of disease can sometimes cause miscarriages, stillbirths, and can affect the baby's health for the rest of his life. Therefore, it is very important to be aware of this.
How is the disease transmitted this way? (Types of Vertical Transmission)
There are three main ways that a disease can be transmitted from mother to baby. Let's take a look at what they are.
1. Through the placenta while the baby is still in the womb (In utero/Transplacental)
What happens in this case is that when a germ enters the mother, it gets into the mother's blood, passes through the placenta, and infects the baby in the womb. The placenta is the connection between the mother and the baby. The mother's nourishment passes through it. So some germs can also pass through this route to the baby. Imagine that, just like the things the mother eats and drinks, the germs in the mother's body can also pass through this placenta to the baby.
2. During childbirth (Intrapartum)
What happens when a baby comes into this world, that is, when it comes through the mother's birth canal, if the mother has any infection, it can also be transmitted to the baby. Imagine that there is some germ in the mother's birth canal. When the baby comes through it, those germs can get on the baby's body, possibly entering the eyes and mouth. This is like walking down a narrow road and getting hit by things on both sides.
3. Breastfeeding after the baby is born (Postpartum)
The third way is to get infected while breastfeeding after the baby is born. Some germs can be passed to the baby through breast milk. Or, if the mother has something like cracked nipples, the germs can be passed to the baby through the blood. That is why breastfeeding mothers need to be careful about their own cleanliness as well as the health of their nipples.
What is the difference between 'Vertical' and 'Horizontal' transmission? (Vertical vs Horizontal Transmission)
Both of these are ways that germs spread from person to person, but there is a slight difference.
'Horizontal transmission' is the way we usually know it. That is, a person can catch a disease from another person through things like coughing, sneezing, having sex, or touching something that has been used. For example, if you talk to a friend who has a cold, when they cough, the germs can get to you and make you sick. That's what 'horizontal transmission' is.
However, 'vertical transmission' refers to the transmission of a disease, especially from a pregnant or breastfeeding mother to her unborn child or newborn. In many cases, these 'vertically' transmitted diseases can also be transmitted 'horizontally'.
What symptoms do babies get from this contagious disease? (Symptoms in Babies)
If the mother passes this disease to the baby, the baby may show various symptoms. Some babies may have these symptoms at birth. For other babies, these symptoms may appear when they are a little older, that is, during childhood. Let's see what these main symptoms are:
- Blindness or vision loss
- Hearing loss or hearing impairment
- Heart disease
- Rash or blisters
- Seizures, that is, seizure-like conditions
- Yellowing of the skin and eyes, we call it jaundice.
- Redness of the eyes, eye disease `(Conjunctivitis)`
- Small, notched teeth
- Some facial differences
- Enlargement of the liver (hepatomegaly) and/or spleen (splenomegaly)
- Small head `(microcephaly)`
- Delays or changes in motor skill development, such as walking and using limbs
Just think, if a newborn baby is constantly yellow, or has small bruises on their body, how important it is to show them to a doctor immediately. If there are such symptoms, it could be the result of an infection from the mother.
What are the infections that can be transmitted from mother to baby? (Infections that can spread vertically)
There are several viral, bacterial, and parasitic diseases that can be transmitted from mother to baby in this way. Doctors use a short name to remember these, which is 'TORCH' .
- T - Toxoplasmosis, Treponema pallidum (which causes the social disease syphilis)
- O - Other means 'other' infections
- R - Rubella `(Rubella)`
- C - Cytomegalovirus
- H - Herpes simplex viruses
Now, there are several other infections that can fall into that 'Other' category. Some of them are:
- Chagas disease
- Chlamydia
- Covid-19 `(COVID-19)`
- Gonorrhea
- Hepatitis viruses (affecting the liver)
- HIV `(HIV)`
- Listeriosis (this can be transmitted through certain foods)
- Parvovirus B19
- Varicella-zoster virus (this is what causes chickenpox)
- Zika virus (transmitted by mosquitoes)
Don't be alarmed by this list. Not everyone will get all of these diseases. But it's important to know that they exist, so we can take steps to protect ourselves from them.
How do pregnant women get these infections?
Now the question is, how does a pregnant or breastfeeding mother develop this disease before her baby is infected? There can be several reasons for this:
- Through unprotected sexual intercourse (oral, anal or vaginal sex). Some sexually transmitted diseases can be transmitted this way and can later be passed on to the baby.
- It can be spread through small droplets (respiratory droplets) that are released when someone coughs or sneezes. For example, it can be spread from someone who has a cold or flu.
- By touching cat poop. In particular, a disease called toxoplasmosis can be transmitted this way. That's why pregnant mothers are told not to touch their cat's litter box.
- A parasite can be transmitted by eating contaminated food or drink. For example, things like vegetables, fruits, and undercooked meat and fish.
- If you are bitten by an insect called the kissing bug (this is not very common in Sri Lanka).
- Through blood donation (blood transfusion). But this is now very rare, because donated blood is tested for germs.
You see, if we are a little careful in our daily lives, we can avoid many of these things.
What are the complications caused by this type of infectious disease?
Transmission of a disease from mother to baby, known as 'vertical transmission', can lead to some serious conditions. For example:
- The risk of miscarriage or stillbirth may increase.
- A baby in the womb may develop fluid buildup or severe swelling (hydrops fetalis).
It's natural to feel scared when you hear these things. But remember, even though these things can happen, you can greatly reduce this risk by being informed in advance, getting the necessary tests, and following your doctor's advice.
How do doctors diagnose this infection? (Diagnosis)
Early in pregnancy, doctors do some blood tests to check for infections that could affect the baby in the womb. If they find that the mother has an infection, doctors may recommend further tests to see if the baby will also be affected. Some of these tests include:
- Amniocentesis: This involves using a small needle to take a small sample of the fluid (amniotic fluid) surrounding the baby and examining its cells.
- Chorionic villus sampling: This involves taking a tissue sample from the placenta and testing it.
- Fetal blood sampling: In this, a thin needle is passed through the mother's abdomen and a blood sample is taken from the baby in the womb and tested.
In newborns and young children, these infections can often be detected with a blood test. If a doctor suspects that the baby is infected with one of the TORCH infections (either because the mother has the disease or because the baby has symptoms), they will test the baby immediately after birth. They can also test for the infection through urine tests or by taking a sample of saliva from the inside of the baby's cheek.
How to treat such diseases? (Treatment)
The treatment for a mother-to-baby infection depends on what type of infection the baby has and when it was discovered. Sometimes, doctors may give antiviral, antibiotic, or antiparasitic medications before or after the baby is born.
The important thing is that while these medications can sometimes reduce the risk of health problems, they may not always prevent them completely. And they cannot reverse damage that has already occurred.
Children who have hearing loss due to congenital infections or developmental problems can receive help from things like speech therapy and occupational therapy.
What to expect if my baby gets this kind of illness?
What happens to your baby if your mother contracts an illness depends on many factors. For example, when the baby got the illness during pregnancy and what kind of illness it was. Generally speaking, the earlier in pregnancy the baby is exposed to the germ, the higher the risk of miscarriage, stillbirth, or a baby being born with a life-threatening condition. But that's not always the case. Early detection and treatment can often prevent many serious consequences.
When should I see a doctor? (When to see a doctor)
This is very important. If you are pregnant, talk to your doctor about getting tested for infectious diseases early in your pregnancy. Also, if you think you may have contracted a sexually transmitted infection (STI), or if you develop any illness during your pregnancy, tell your doctor right away. Don't ignore it. Even if it's a small thing for you, it can have a big impact on your baby.
Can vertical transmission be prevented?
Yes! There are things we can do to prevent this to a large extent. If you have an infection that could be passed on to your baby during pregnancy or after delivery, it can be treated with antibiotics, antivirals, or antiparasitic medications. This can reduce the risk of passing the disease on to your baby. In addition, here are some things you can do to protect yourself from infections:
- Always wash your hands thoroughly with soap. Be sure to wash your hands after going outside, before eating, and after using the toilet.
- Wear gloves when working in the garden or cleaning the house. Wash your hands thoroughly when you are finished.
- Minimize your visits to crowded places as much as possible. If you must go, wear a mask. Be especially careful during flu season and when there are many COVID-19 patients.
- Ask your doctor about the vaccinations that are recommended for you and get them all on time. Some vaccines can protect against diseases that can be transmitted from mother to baby in this way. For example, the rubella vaccine.
- Practice safe sex. Use condoms if you have sex during pregnancy. It's also a good idea to have your partner tested for sexually transmitted infections (STIs).
- Do not attempt to clean the cat litter box yourself during pregnancy. If you absolutely must, wear gloves and wash your hands thoroughly after you are done.
- When preparing food, prepare it cleanly and properly. Boil and cook meat and fish thoroughly before eating. Wash fruits and vegetables thoroughly, peeling them if possible.
- Eat only safe foods. Do not drink unpasteurized milk or untreated water. Do not eat raw or undercooked shellfish, such as oysters and mussels.
- Protect yourself from insects. To protect yourself from insects like mosquitoes, apply insect repellants and wear long clothing.
- If you are going on a long trip, plan ahead. Especially if you are going abroad while pregnant, it is a good idea to seek advice from a ``travel medicine clinic``. They will give you advice specific to the country you are going to.
Also, if you are pregnant, trying to get pregnant, or have traveled to an area where Chagas disease is prevalent, consider getting tested for the disease.
Take-Home Message
Okay, so I hope you now have a good understanding of what we talked about today, called 'vertical transmission'. Simply put, this is the transmission of diseases from mother to baby during pregnancy, childbirth, or breastfeeding. This can lead to serious, lifelong complications, so it's important to take extra precautions to stay safe while you're pregnant or trying to get pregnant.
If you are pregnant, think you may have contracted an infection, or have any symptoms, talk to your doctor right away. Don't ignore anything that seems minor.
Awareness is the best defense. I hope you take these precautions and find the strength to bring a healthy baby into this world!
` vertical transmission, pregnancy, childbirth, breastfeeding, infections, TORCH, congenital conditions, prevention
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