Intersecting Infections and Socioeconomic Determinants in Adverse Pregnancy Outcomes: An Integrative Review | ||
| Egyptian Reviews for Medical and Health Sciences | ||
| Volume 5, Issue 1, June 2025, Pages 111-128 PDF (1.06 M) | ||
| Document Type: Review article | ||
| DOI: 10.21608/ermhs.2025.400643.1060 | ||
| Authors | ||
| Shamsi abdullah saad shamsi* 1; Asmaa Ali Makhlouf2; Hasan Mohamed Ibrahim1 | ||
| 1Department of Medical Laboratory , Faculty Of Medical Technology , Sebha university | ||
| 2Obstetrics and Gynecology Department, Sebha Medical Center, Sebha, Libya | ||
| Abstract | ||
| Pregnancy-related co-infections, particularly in resource-limited settings, pose significant challenges to maternal and fetal health outcomes. This review explores the complex interactions among HIV, malaria, helminths, and arboviruses during pregnancy and how socioeconomic determinants, such as poverty, education, and healthcare access, amplify infection risks and adverse outcomes. Immunological shifts during pregnancy, characterized by a Th2-biased response, increase susceptibility to intracellular pathogens, while helminth infections further exacerbate this vulnerability. Placental malperfusion, driven by dysregulated angiogenic factors and structural abnormalities, is a key mechanism underlying adverse outcomes in HIV-malaria co-infected pregnancies. Arboviral infections, particularly Zika virus, pose teratogenic risks, while Dengue and Chikungunya viruses contribute to maternal and fetal morbidity. Malnutrition, exemplified by deficiencies in iron, folate, and vitamins A and D, compromises maternal immunity and creates a vicious cycle of infection and adverse outcomes. Emerging diagnostic technologies such as CRISPR-based tools and AI-driven platforms offer promising solutions for the rapid and accurate detection of co-infections. Novel therapeutic strategies, including combination antimalarial and antiretroviral regimens, vaccines, and anthelmintic interventions, have the potential to mitigate the impact of co-infections. However, evidence gaps persist, particularly regarding long-term maternal and child outcomes and the impact of climate change on infectious disease dynamics. Integrated care models that address multiple infections, improve nutrition, and ensure comprehensive healthcare access are crucial for reducing the burden of coinfections during pregnancy. Strengthening healthcare infrastructure, expanding educational programs, and investing in climate adaptation strategies are key policy recommendations for protecting vulnerable populations and improving maternal and fetal health outcomes in high-burden areas. | ||
| Keywords | ||
| Immunological Modulation; Vertical Transmission; Placental Dysfunction; Diagnostic Innovation; Public Health Equity | ||
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