The hateful eight: serological testing in pregnancy
Congenital and perinatal infections still represent a serious health hazard for newborns and infants. Many bacterial, viral and protozoal infections may be transmitted from the mother to the fetus or the newborn. In this review we shall deal only with the latter two groups of infectious agents focusing on those that have a larger diffusion and a greater impact and for which criteria for the serological diagnosis have been established. Among viral infections we shall then consider rubella virus (RV), human cytomegalovirus (CMV), parvovirus B19 (ParvoB19), hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and Zika virus (ZIKV) and for parasitic infections, we will focus on Toxoplasma gondii (T. gondii). For each of those a summary of the characteristics of the pathogen, the frequency of transmission and the sequelae to the newborns and infants are provided and the description of the available screening tools in potentially infected pregnant women are described, with special attention to the unmet needs and controversies. Finally, the indication of the available or potential vaccines and of the possibility to prevent transmission by pharmacological treatment is also provided.