Congenital, intrauterine, perinatal, and postnatal infections in newborns (review of current clinical guidelines)

The publication provides clinical and diagnostic features of congenital, intrauterine, perinatal and postnatal infections in newborns based on a review of current clinical guidelines. There are common patterns and similar clinical manifestations for all of these infections, but there are significant differences. Attention is paid to the importance of isolating the “TORCH” syndrome in newborn children in order to carry out subsequent diagnosis of the etiology of infection. Additional information about intraamniotic infection is provided. Methods of laboratory diagnosis of infection are presented. Direct methods are described: microscopy, polymerase chain reaction, bacteriological (culture) method. Among the indirect diagnostic methods, information is provided on enzyme immunoassay, determination of immunoglobulins M and G. Attention is paid to the importance of studying the avidity of immunoglobulins G. The detection of low-avidity antibodies confirms acute infection. The presence of highly specific antibodies makes it possible to establish a history of infection. The advantages and disadvantages of direct and indirect methods of diagnosing infection in children are described. First of all, patients should be examined for those infections for which etiological and pathogenetic treatment has been developed. The main goal of therapy is to reduce the replication of the infectious agent in order to prevent damage to cells and tissues. The criterion for the effectiveness of therapy is considered to be the positive dynamics of the child’s condition, as well as the negative results of the polymerase chain reaction.

1. Neonatology: National guidelines: in 2 volumes. Volume 1. Ed. Volodina N.N., Degtyareva D.N. 2nd ed., revised and add. Moscow: GEOTAR-Media, 2023; 752p. (In Russ.) https://doi.org/10.33029/9704-7828-8-NNG-2023-1-752

2. Neonatology: National guidelines: in 2 volumes. Volume 2. Edited by Volodina N.N., Degtyareva D.N. 2nd ed., revised and add. Moscow: GEOTAR-Media, 2023; 768p. (In Russ.) https://doi.org/10.33029/9704-7829-5-NNG-2023-1-768

3. Kravchenko E.N., Kuklina L.V., Shevlyukova T.P. Intrauterine infection: risk factors and diagnostic problems during pregnancy. Obstetrics and gynecology: news, opinions, training. 2023;11 (4):35-44. (In Russ.) https://doi.org/10.33029/2303-9698-2023-11-4-35-44

4. Kuzmin V.N., Adamyan L.V. The problem of intrauterine infection in modern obstetrics. Infectious diseases: news, opinions, education. 2017;3:32-36. (In Russ.) https://doi.org/10.24411/2305-3496-2017-00048

5. Posiseeva L.V. Intrauterine infection: questions and answers. Issues of gynecology, obstetrics and perinatology. 2020;2:124-128. (In Russ.) https://doi.org/10.20953/1726-1678-2020-2-124-128

6. Congenital perinatal viral infections: A teaching aid. Moscow: V.F. Voino-Yasenetsky Scientific and Practical Center for Specialized Medical Care for Children, 2025; 109p. (In Russ.)

7. Intrauterine infections: diagnosis, treatment, and prevention. Zaplatnikov A.L., Korovina N.A., Korneva M.Yu., Cheburkin A.V. Emergency medicine. 2013;1(48):25–33. (In Russ.)

8. Neonatology. Clinical recommendations. Edited by Volodina N.N., Degtyareva D.N., Kryuchko D.S. Moscow: GEOTAR-Media, 2021; 320p. (In Russ.).

9. Neonatology: in 2 vols. Vol. 2.: text-book. Edited by N.P. Shabalov. 7th ed., revised Moscow: GEOTAR-Media, 2023; 752p. (In Russ.)

10. Lino J.F., Diniz L.M.O., Rezende L.G., Costa V.F.T., Romanelli R.M.C. Diagnosis of congenital infections in premature, low-birthweight newborns with intrauterine growth restriction caused by cytomegalovirus (CMV), herpes simplex virus (HSV), Parvo-B 19, and Zika virus: a systematic review. J Perinat Med. 2022 Apr 18;50(7):993-1000. https://doi.org/10.1515/jpm-2021-0244

11. Gigi C.E., Anumba D.O.C. Parvovirus b19 infection in pregnancy – A review. Eur J Obstet Gynecol Reprod Biol. 2021;264: 358-362. https://doi.org/10.1016/j.ejogrb.2021.07.046

12. Kimberlin D.W., Barnett E.D., Lynfield R., Sawyer M.H. Red Book: 2021–2024 Report of the Committee on Infectious Diseases. 32nd edition. American Academy of Pediatrics, 2021; 1194p.

13. Neonatal sepsis. Clinical guidelines. Alexandrovich Yu.S., Balashova E.N., Boronina I.V. and others M. 2024; 91c. [cited 2025 Dec 20]. https://neonatology.pro/wp-content/uploads/2024/09/draft_cr_neonatal-sepsis_17092024.pdf (In Russ.).

14. Alexandrovich Y.S., Balashova E.N., Boronina I.V., Zavialova A.N., Zolotareva L.S., Ivanov D.O., Kirilochev O.K., Lisitsa I.A., Makulova A.I., Mironov P.I., Osokina R.A., Pavlovskaya E.Yu., Popov D.A., Pshenisnov K.V., Sergeeva V.A., Serednyakov K.V., Fedorova L.A., Agafonova A.V. Neonatal sepsis (Draft federal clinical guidelines). Pediatrician. 2024;15(4): 5-53. (In Russ.) https://doi.org/10.17816/PED1545-53

15. Congenital pneumonia. Clinical recommendations. Andreeva I.V., Baibarina E.N., Balashova E.N. et al. M. 2025; 65p. (In Russ.)

16. Nikitina I.V., Gerasimova A.V., Ivanova L.A., Krog-Jensen O.A., Isaeva E.L., Lenyushkina A.A., Priputnevich T.V., Degtyarev D.N. Infections associated with medical care in critically ill premature infants: epidemiology, clinical picture and diagnosis in modern conditions. Neonatology: news, opinions, training. 2020;3:7-17. (In Russ.) https://doi.org/10.33029/2308-2402-2020-8-3-7-17

17. Congenital cytomegalovirus infection. Clinical recommendations. Akhapkina E.S., Balashova E.N., Volodin N.N. et al. M. 2025; 62p. (In Russ.)

18. Pinninti S., Boppana S. Congenital cytomegalovirus infection diagnostics and management. Curr Opin Infect Dis. 2022;35(5):436-441. https://doi.org/10.1097/QCO.0000000000000874

19. Angueyra C., Abou Hatab H., Pathak A. Congenital cytomegalovirus and Zika Infections. Indian J. Pediatr. 2020;10:840-845. https://doi.org/10.1007/s12098-020-03260-9

20. Balashova E.N., Vasiliev V.V., Weinstein N.P., Degtyareva M.V., Zubkov V.V., Ivanova A.A., Ignatko I.V., Karpova A.L., Lobzin Yu.V., Malyutina L.V., Ovsyannikov D.Yu., Pankratieva L.L., Savenkova M.S., Senkevich O.A., Shakhgildyan V.I., Shabalov N.P., Ionov O.V., Degtyarev D.N., Volodin N.N. Congenital cytomegalovirus infection (clinical recommendations). Neonatology: news, opinions, training. 2023;11(4):68–87. (In Russ.) https://doi.org/10.33029/2308-2402-2023-11-4-68-87

21. Congenital infection caused by the herpes simplex virus. Clinical recommendations. Balashova E.N., Volodin N.N., Gorev V.V. et.al. M. 2025; 73p. [cited 2025 Dec 20]. Available from: https://neonatology.pro/wp-content/uploads/2025/02/draft_cr_herpes-simplex_23022025.pdf (In Russ.).

22. Congenital ureaplasma, mycoplasma and chlamydia infection. Clinical recommendations. Balashova E.N., Boehm E.V., Ivanov D.O. et al. M. 2025; 49p. [cited 2025 Dec 20]. https://neonatology.pro/wp-content/uploads/2024/11/draft_cr_congenital-ureaplasma-mycoplasma-chlamydial-infection_22112024.pdf (In Russ.).

23. Ivanov D.O., Boehm E.V., Panchenko A.S., Balashova E.N., Chumakova G.N., Levadneva M.I., Myznikova I.V., Pavlova S.E., Romanova L.A., Fedorova L.A., Yakovleva E.E. Practical recommendations for neonatologists and pediatricians «Congenital ureaplasma, mycoplasma and chlamydia infections» (Draft clinical recommendations for discussion by specialists). Pediatrician. 2024;15(6):5-23. (In Russ.) https://doi.org/10.17816/PED1565-23

24. Infection specific to the perinatal period. Clinical recommendations. Balashova E.N., Belousova T.V., Boehm E.V. et al. M., 2025; 63p. [cited 2025 Dec 20]. Available from: https://neonatology.pro/wp-content/uploads/2024/10/draft_cr_infection-specific-perinatal-period_08102024.pdf (In Russ.).

25. Ivanov D.O., Panchenko A.S., Fedorova L.A., Balashova E.N., Boehm E.V., Zelenin N.M., Myznikova I.V., Levadneva M.I., Nabieva A.S., Pavlova S.E., Romanova L.A., Chumakova G.N., Yakovleva E.E., Belousova T.V., Izvekova I.Ya., Ovsyannikov D.Yu. Diagnosis and treatment of infection specific to the perinatal period (Draft clinical recommendations for discussion by neonatologists and pediatricians). Pediatrician. 2024;15(3):5-25. (In Russ.) https://doi.org/10.17816/PED1535-25.

26. Jain V.G., Willis K.A., Jobe A., Ambalavanan N. Chorioamnionitis and neonatal outcomes. Pediatr Res. 2022;91(2):289-296. https://doi.org/10.1038/s41390-021-01633-0

27. Kravchenko E.N., Kuklina L.V., Baranov I.I. Chorioamnionitis. A modern view of the problem. Doctor. Ru. 2022; 5:38-42. (In Russ.) https://doi.org/10.31550/1727-2378-2022-21-5-38-42

28. Candidiasis of newborns. Clinical recommendations. Akhapkina E.S., Balashova E.N., Volodin N.N. et al. M. 2025; 56p. (In Russ.)

29. Order of the Ministry of Health of the Russian Federation dated 10.20.2020. N1130n «On approval of the Procedure for providing medical care in the field of obstetrics and gynecology» [cited 2025 Dec 20]. https://base.garant.ru/74840123/ (In Russ.).

30. Neu N., Duchon J., Zachariah P. TORCH infections. Clin Perinatol. 2015;42(1):77-103. https://doi.org/10.1016/j.clp.2014.11.001

31. Zhang Y., Zhang Y., Wang J., Lin L., Chai J., Liu J., Zhang J., Gao Y., Sun P., Wang C., Jiang L., Li D., Zhang Y., Gu X., Zhang C., Wang Y., Ma X. Analysis of TORCH screening and prenatal risk assessment for childbearing-age women in different regions of China. J Health Popul Nutr. 2025;44(1):331. https://doi.org/10.1186/s41043-025-01084-x.