Antenatal infections with Candida species

Area of Science:

• Perinatology
• Infectious Diseases
• Neonatology

Background:

• Intrauterine infections pose significant risks to both mother and fetus.
• Candida species are opportunistic pathogens that can cause severe infections.

Purpose of the Study:

• To describe the clinical, pathological, and microbiological features of pregnancies with intrauterine Candida infections.
• To identify risk factors associated with Candida chorioamnionitis.

Main Methods:

• Retrospective case series of 18 pregnancies with intrauterine Candida sp. infection.
• Macroscopic examination of fetal membranes and umbilical cord.
• Case-control study to identify associations with maternal factors.

Main Results:

• Candida chorioamnionitis is recognizable macroscopically at birth.
• Fetal inflammatory response is noted with umbilical cord and membrane penetration.
• Infections in very low birthweight infants present as pneumonia or skin infections.
• Candida was frequently recovered from gastric aspirates of affected infants.
• A strong association exists between Candida chorioamnionitis and maternal foreign bodies (IUDs, cervical sutures).

Conclusions:

• Candida chorioamnionitis presents with distinct clinical and pathological findings.
• Maternal foreign bodies are a significant risk factor for Candida chorioamnionitis.
• High neutrophil counts in preterm infants with a history of maternal foreign bodies warrant suspicion for Candida infection.