Infections during pregnancy: An ongoing threat

Congenital infections are an ongoing relevant cause of congenital and perinatal abnormalities since effective vaccination is not available for many diseases. Moreover, climate change, mutational evolution of pathogens, or their vectors associated with intense human traveling predispose to outbreaks and modification of the geographic distribution of traditionally limited infectious diseases. Here, we review the so-called TORCH infections (toxoplasmosis, others, rubella, cytomegalovirus, herpes) with a special emphasis on the arboviral infections (zika, dengue, chikungunya, oropouche). Although respiratory viruses are rarely transmitted through the placenta, the maternal condition itself can cause adverse effects on the developing embryo/fetus (COVID-19, influenza). Some perinatal-acquired infections will also be briefly discussed due to their relevance in the child's development. The majority of teratogenic congenital and some perinatal-acquired infections have effects on the central nervous system or sensory organs with long-lasting disabilities. Vaccines are unavailable for several teratogenic or perinatal infections, and treatment options are still limited, particularly for arboviral and other emergent diseases. Social inequalities are associated with the prevalence, fetal outcomes and long-term disabilities of these diseases. The One Health approach could be an essential way to reduce the burden of these diseases in the population.