Maternal infection in pregnancy

Abstract This chapter will consider infection with human immunodeficiency virus (HIV), tuberculosis, and malaria in pregnancy. The global roll-out of antiretroviral therapy has significantly improved survival for people living with HIV and reduced mother-to-child transmission, but HIV infection remains a leading cause of maternal mortality, infant death, and early childhood death. Most women with HIV infection are in sub-Saharan Africa, where the highest prevalence is among young women of reproductive age. Meanwhile, tuberculosis is a major cause of maternal mortality. Active tuberculosis also adversely affects pregnancy outcomes, with an increased risk of preterm delivery, growth restriction, and perinatal death. Malaria is a major cause of maternal and neonatal morbidity and mortality. Pregnant women are more susceptible to malaria, have more severe disease, and may deteriorate rapidly. In severe malaria, mortality is 15–20% in non-pregnant women, compared to 50% in pregnancy. Primigravidae are at highest risk of severe malaria and death.