Antenatal screening in Europe: How to avoid mother-to-child transmission of infections

March 21, 2017
Transmission of infections with HIV, hepatitis B, syphilis or rubella from mother to child before and during birth as well as in infancy still occur across Europe. Credit: ECDC

Transmission of infections with HIV, hepatitis B, syphilis or rubella from mother to child before and during birth as well as in infancy still occur across Europe - despite existing prevention methods. A new ECDC report outlines the cornerstones for effective antenatal screening programmes across the EU/EEA countries.

Each year, more than five million live births are recorded in the European Union. Almost as many are screened for infections - namely for HIV, syphilis, hepatitis B and rubella susceptibility - in order to prevent possible mother-to-child transmission (MTCT).

However, children are still being born with these infections in the EU/EEA. For example, 424 congenital syphilis infections and 274 HIV infections were reported in children born between 2010 and 2014.

In its evidence-based guidance, ECDC aims to help Member States to strengthen antenatal screening in the general population and in particular among vulnerable groups for MTCT.

The guidance looks at which elements of a national antenatal screening programme for infections influence effectiveness, and which are the specific approaches to be used for reaching the vulnerable groups in order to increase the uptake of prenatal care and reduce mother-to-child transmission. The guidance is accompanied by two technical reports of literature reviews.

Among the main proposals for effective antenatal screening are:

  • Testing for HIV, syphilis and hepatitis B during the first trimester of pregnancy.
  • Repeat testing offer during the third trimester for pregnant at increased risk of infection and/or for those who previously refused testing.
  • Testing at delivery to women who had not previously been tested.
  • For HIV and syphilis in particular, a universal approach should be considered for the antenatal screening, which means voluntary testing for all pregnant women with an opt-out possibility.

To improve the uptake of antenatal testing among vulnerable groups like migrant women or women at higher risk for infections due to injecting drug use or those engaging in high risk sexual practices, several options may be considered.

This includes addressing communication barriers regarding language, literacy levels, or individual or cultural specifics, and improving access to antenatal care through outreach services and informal networks can help.

Why test for infections during pregnancy?

Mother-to-child transmission is the most predominant mode of HIV infection in young children worldwide. Without intervention, the risk of HIV transmission from an infected mother to her child ranges from 15% to 30% during pregnancy/delivery to between 10% and 20% during breastfeeding. This risk can be reduced to 1 to 2% with a combination of appropriate antenatal interventions including antiretroviral therapy (ART) for the mother, antiretroviral prophylaxis for the newborn, and avoidance of breastfeeding.

Transmission of hepatitis B from mother to child is preventable in 95% of all cases through the administration of vaccine and immunoglobulin to the baby at birth. With no immunoprophylaxis, more than 90% of infants infected by their positive mothers will go on to develop chronic .

There is no treatment for rubella but MTCT can be prevented by ensuring that all women who plan to get pregnant are immune or have been immunised against rubella.

Read the full report Antenatal screening for HIV, hepatitis B, syphilis and rubella susceptibility in the EU/EEA - addressing the vulnerable populations

Explore further: Mother-child HIV transmission at all time low in U.K. and Ireland

Related Stories

Mother-child HIV transmission at all time low in U.K. and Ireland

December 8, 2016
The number of mothers passing the HIV virus to their babies has fallen to a new record low in the UK and Ireland thanks to the very high take-up of antenatal HIV screening and treatment which reduces virus levels in the pregnant ...

Mother-to-child HIV transmission low, but more progress possible

March 13, 2017
(HealthDay)—A small proportion of HIV-infected women continue to transmit the virus to their neonates despite access to high-quality care, according to research published in the April issue of Obstetrics & Gynecology.

Syphilis screening and treatment in pregnancy may be cost-effective in sub-Saharan Africa

November 5, 2013
Screening and treating pregnant women in sub Saharan Africa for syphilis* may be a cost-effective use of resources, according to a study published in this week's PLOS Medicine. The study by Mohammed Lamorde from Uganda's ...

Over million pregnant women infected with syphilis world-wide

February 26, 2013
Syphilis still affects large numbers of pregnant women world-wide, causing serious health problems and even death to their babies, yet this infection could be prevented by early testing and treatment, according to a study ...

Mother to child HIV transmission at record low in the UK

February 25, 2014
The rate of mother to child HIV transmission is at an all-time low in the UK, according to a paper published today in the journal AIDS.

Cuba becomes first nation to eliminate mother-to-child HIV

June 30, 2015
Cuba on Tuesday became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis, the World Health Organization said.

Recommended for you

Urine test developed to test for tuberculosis

December 14, 2017
(Medical Xpress)—An international team of researchers has developed a urine test that can be used to detect tuberculosis (TB) in human patients. In their paper published in Science Translational Medicine, the group describes ...

40 years after first Ebola outbreak, survivors show signs they can stave off new infection

December 14, 2017
Survivors of the first known Ebola outbreak, which occurred in the Democratic Republic of the Congo in 1976, may be key to development of vaccines and therapeutic drugs to treat future outbreaks, according to a new study ...

Aging impairs innate immune response to flu

December 13, 2017
Aging impairs the immune system's response to the flu virus in multiple ways, weakening resistance in older adults, according to a Yale study. The research reveals why older people are at increased risk of illness and death ...

Lyme bacteria survive 28-day course of antibiotics months after infection

December 13, 2017
Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, today announced results of two papers published in the peer-reviewed journals PLOS ONE and American Journal of Pathology, that seem to support ...

Drug blocks Zika, other mosquito-borne viruses in cell cultures

December 12, 2017
If there was a Mafia crime family of the virus world, it might be flaviviruses.

Study seeks to aid diagnosis, management of catatonia

December 11, 2017
Catatonia, a syndrome of motor, emotional and behavioral abnormalities frequently characterized by muscular rigidity and a trance-like mental stupor and at times manifesting with great excitement or agitation, can occur during ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.