Enemies of the Unborn

The lowly cause of what is usually a lowly and unimportant disease, German measles (or rubella), long enjoyed the unsavory reputation of being the only virus clearly convicted of killing or crippling babies in the womb. But many other viruses are now emerging from researchers' culture tubes to qualify as enemies of the unborn.

A pregnant woman's viral infections may damage the baby in four ways: 1) by causing prompt abortion; 2) by killing the fetus, leading to later stillbirth; 3) by preventing normal development of organs, so that the baby is born deformed; 4) by infecting the baby so that its first days or weeks of independent life are an uphill struggle against disease. Viruses may strike at any time from the first few days after conception to the moment of delivery.

Among the latest findings from the laboratories of pediatric virologists:

> Abortion and stillbirth commonly result from infections with the viruses of smallpox, ordinary measles (rubeola), polio, influenza and, less often, mumps. Measles works fast and is deadly to the fetus probably because of the high fever that accompanies the appearance of the red spots. Polio is not a deformer of the unborn, and usually is not deadly if the mother's infection comes late in pregnancy. But polio sometimes causes premature birth.

> Smallpox vaccination during the first three months of pregnancy has caused some malformations in babies, but the vaccine, all from the same batch, was unusually virulent. If a woman is vaccinated for the first time while she is pregnant, there is a risk that the baby will be born with a disfiguring or fatal case of cowpox. But if a pregnant woman is going to an area where smallpox always smolders, she should be vaccinated anyway, because the smallpox is far deadlier than any vaccine.

> Infection with what is awkwardly called cytomegalic inclusion disease (it has no familiar name) is hard to distinguish from other sniffles and fevers, but may cause babies to be born with virtually no skull or brain cortex, reports Boston's Dr. Thomas H. Weller, a Nobel prizewinner for his work on the polio virus. Some infant victims appear almost normal at birth, but then become microcephalic ("pinheads") because their skulls fail to grow.

Kidney defects or malformed hearts in newborn infants show a definite relationship to at least four viruses--three of the Coxsackie and one of the Echo group, all distantly related to poliovirus. The infection may be so mild that the mother-to-be does not appear ill. To get their evidence, University of Michigan researchers followed 4,000 women through pregnancy, making frequent tests of blood antibodies to keep tab on the viruses they had picked up.

> Herpes simplex infections in the newborn, ranging in severity from little ulcers in the mouth to a crippling encephalitis, were always believed to have been picked up while the baby was passing through the birth canal. This is not necessarily so, say Drs. Joe E. Mitchell and Fred C. McCall of Bristol, Tenn. They describe a baby who was born with herpetic ulcers on his skin and kept getting them for months; he is now handicapped by cerebral palsy. By diligent virus detective work, the doctors concluded that the mother had picked up the infection from her husband, who had a herpes simplex fever blister on his lip when he kissed her ten days before the baby was born. The virus must have reached the baby through the mother's bloodstream and the placenta.

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