Congenital Rubella Infection
المؤلف:
Mary Louise Turgeon
المصدر:
Immunology & Serology in Laboratory Medicine
الجزء والصفحة:
5th E, P316-317
2025-09-07
476
Rubella infection is usually a mild, self-limiting disease with only rare complications in children and adults. In pregnant women, however, especially those infected in the first trimester, rubella can have devastating effects on the fetus (Fig.1). In utero infection can result in fetal death or manifest as rubella syndrome, a spectrum of congenital defects. About 10% to 20% of infants infected in utero fail to survive beyond 18 months.
Fig1. Congenital malformations of rubella. (From Krugman S et al: Infectious diseases of children, ed 8, St Louis, 1985, Mosby.)
The point in the gestation cycle at which maternal rubella infection occurs greatly influences the severity of congenital rubella syndrome (Table 1); the extent of congenital anomalies varies from one infant to another. Some infants manifest almost all the defects associated with rubella, whereas others exhibit few, if any, consequences of infection. Clinical evidence of congenital rubella infection may not be recognized for months or even years after birth.
Table1. Manifestation of Anomalies in Maternal Rubella
Rubella syndrome encompasses a number of congenital anomalies. In addition to stillbirth, fetal abnormalities associated with maternal rubella infection include encephalitis, hepatomegaly, bone defects, mental retardation, cataracts, thrombocytopenic purpura, cardiovascular defects, splenomegaly, and microcephaly. Severely affected children are likely to have multiple defects in different organ systems. In neonates with con genital rubella syndrome, low birth weight and failure to thrive are common.
Rubella immunity develops in almost all children who have had congenital rubella. In late childhood, however, about one third of these patients lose antibody and become susceptible to acquired rubella. If acquired rubella occurs, it follows a typically benign course. Children with congenital rubella should be screened for rubella immunity in late childhood and vaccinated if necessary.
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