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Factors in the mother/infant dyad that influence the development of infections before and after birth.

A number of maternal factors strongly influence the development and outcome of fetal infections. Severely undernourished mothers produce neonates with evidence of an immunoincompetence that persists into later childhood. Mothers who fast during pregnancy develop metabolic acidosis much more rapidly than non-pregnant women. The metabolic acidosis leads to high fetal and neonatal death rates from a variety of pre-existing disorders, including infections. Such metabolic acidosis also appears responsible for the excessive fetal and neonatal deaths associated with maternal urinary tract infections. Finally, coitus during pregnancy markedly increases both the frequency of bacterial infections of amniotic fluid and the mortality due to them. The effects are greatest at mid-pregnancy and gradually decrease to term.