Infections in pregnancy

Also called Toxoplasmosis, Listeriosis, Cytomegalovirus, CMV

A handful of infections harm a developing baby. Most of the prevention is about food, cat litter and handwashing after toddlers.

What it is

Several infections that are mild or symptomless in an adult and can seriously harm a developing baby.

**Cytomegalovirus is the commonest infectious cause of congenital disability in the UK**, and almost nobody has heard of it. It causes more childhood deafness and disability than many conditions that are far better known. It spreads mainly through the saliva and urine of young children, so pregnant women with toddlers are the group at risk. Prevention is straightforward and effective: not sharing food, cutlery or drinks with a toddler, not putting a dummy in your own mouth, avoiding kissing a young child on the mouth, and washing hands after nappies and wiping noses.

**Listeriosis** comes from foods including unpasteurised dairy, soft mould-ripened and blue cheeses, pâté, and chilled ready-to-eat foods. It causes miscarriage, stillbirth and severe newborn infection.

**Toxoplasmosis** comes from cat faeces, soil, and undercooked or cured meat. It causes eye and brain damage.

Also relevant: group B strep, chickenpox, rubella, slapped cheek syndrome, genital herpes and sexually transmitted infections, each covered separately.

Routine antenatal screening covers HIV, hepatitis B and syphilis; it does not cover CMV, toxoplasmosis or listeria, which is why prevention advice matters.

Signs you might notice

Usually nothing. Most of these infections cause no symptoms or a mild flu-like illness in the mother.

CMV: sometimes a flu-like illness with fever, sore throat and tiredness.

Listeriosis: fever, aches, sometimes vomiting and diarrhoea. It can be mild and still harm the baby.

Toxoplasmosis: usually nothing, sometimes swollen glands and a flu-like illness.

**Contact a midwife for: any fever in pregnancy; a flu-like illness; a rash; contact with anybody with a rash; or reduced fetal movements at any time.**

Urgent: fever with abdominal pain, reduced fetal movements, leaking fluid, or feeling very unwell.

After birth, in the baby: jaundice, a small head, poor feeding, a rash of small purple spots, seizures, or failing the newborn hearing screen, all of which need urgent paediatric assessment.

How it can affect day-to-day life

The CMV advice is the most valuable and least given. It costs nothing, it is simple, and it prevents the commonest infectious cause of congenital disability. Nursery and childcare workers who are pregnant are a particular group who should be told.

The food advice is often delivered as a long forbidden list that people either ignore or obsess over. The practical core is: avoid unpasteurised dairy, mould-ripened and blue cheeses, pâté and undercooked meat; reheat chilled ready-to-eat foods thoroughly; wash fruit, vegetables and salad; and observe use-by dates.

Cats do not need to be rehomed. Wear gloves for the litter tray, or have somebody else do it, change it daily since the parasite takes a day to become infectious, and wear gloves for gardening.

Hand washing after nappies, and after wiping a toddler's nose, is the single highest-yield habit in this entry.

Guilt is a real burden when an infection does occur, and it is misplaced; these infections are common, often unavoidable, and not a failure of care.

Supporting someone well

For CMV: do not share food, cutlery, drinks or a dummy with a young child; kiss on the head not the mouth; wash hands after nappies and noses.

Avoid unpasteurised dairy, mould-ripened and blue cheeses, pâté, and undercooked or cured meat.

Reheat chilled ready-to-eat food thoroughly, and observe use-by dates.

Wash fruit, vegetables and salad thoroughly.

Wear gloves for the cat litter tray and for gardening; change litter daily.

Report any fever, rash, flu-like illness or contact with a rash to the midwife.

Report reduced fetal movements immediately, at any hour.

Check MMR and chickenpox immunity before pregnancy.

Attend all antenatal screening.

Where to get help

A midwife or maternity unit, the same day, for fever, rash or feeling unwell.

A GP practice for pre-pregnancy immunity checks.

Tommy's midwives on 0800 014 7800.

Group B Strep Support and Sands for related risks and for bereavement support.