Beyond TORCH: A narrative review of the impact of antenatal and perinatal infections on the risk of disability

Infections and inflammation during pregnancy or early life can alter child neurodevelopment and increase the risk for structural brain abnormalities and mental health disorders. There is strong evidence that TORCH infections (i.e., Treponema pallidum, Toxoplasma gondii, rubella virus, cytomegaloviru...

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Published in:	Neuroscience and biobehavioral reviews Vol. 153; p. 105390
Main Authors:	Devaraju, Monica, Li, Amanda, Ha, Sandy, Li, Miranda, Shivakumar, Megana, Li, Hanning, Nishiguchi, Erika Phelps, Gérardin, Patrick, Waldorf, Kristina Adams, al-Haddad, Benjamin J.S.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Ltd 01-10-2023
Subjects:	Behavioral disabilities Cognitive and intellectual disability Cytomegalovirus Female Humans Infant, Newborn Inflammation Learning disability Maternal immune activation Mental Disorders Motor skills disorders Neurodevelopment Neurodevelopmental delay Perinatal complications Pregnancy Pregnancy Complications, Infectious - microbiology Sensory disabilities Speech language disorders TORCH infections Toxoplasma RR Cognitive and intellectual disability OR Maternal immune activation Perinatal complications Behavioral disabilities TORCH infections HR HSV Speech language disorders CMV CP Motor skills disorders Neurodevelopmental delay LPS HIV Learning disability TORCH Neurodevelopment Sensory disabilities CHIKV
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Summary:	Infections and inflammation during pregnancy or early life can alter child neurodevelopment and increase the risk for structural brain abnormalities and mental health disorders. There is strong evidence that TORCH infections (i.e., Treponema pallidum, Toxoplasma gondii, rubella virus, cytomegalovirus, herpes virus) alter fetal neurodevelopment across multiple developmental domains and contribute to motor and cognitive disabilities. However, the impact of a broader range of viral and bacterial infections on fetal development and disability is less well understood. We performed a literature review of human studies to identify gaps in the link between maternal infections, inflammation, and several neurodevelopmental domains. We found strong and moderate evidence respectively for a higher risk of motor and cognitive delays and disabilities in offspring exposed to a range of non-TORCH pathogens during fetal life. In contrast, there is little evidence for an increased risk of language and sensory disabilities. While guidelines for TORCH infection prevention during pregnancy are common, further consideration for prevention of non-TORCH infections during pregnancy for fetal neuroprotection may be warranted. •We reviewed the evidence for developmental effects of fetal exposure to maternal non-TORCH infections.•We found strong evidence for increased risk of motor disability after fetal exposure to maternal non-TORCH infections.•We found moderate evidence for increased risk of cognitive disability after fetal exposure to maternal non-TORCH infection.•There was little evidence for increased risk of language or sensory disability.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 Writing – Original Draft Preparation: M.D., A.L., S.H., M.L., M.S., V.L., E.P.N., P.G., K.A.W, B.J.S.H. Conceptualization: M.D., A.L., K.A.W, B.J.S.H. Supervision: K.A.W; B.J.S.H. Methodology: M.D.; A.L.; K.A.W; B.J.S.H. Writing – Review & Editing: M.D., A.L., S.H., M.L., M.S., V.L., E.P.N., P.G., K.A.W, B.J.S.H. Equal contribution Author Contributions
ISSN:	0149-7634 1873-7528 1873-7528
DOI:	10.1016/j.neubiorev.2023.105390