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Infectious diseases of the fetus and newborn infant, 6th edn
  1. A C Breeze

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Edited by Jack S Remington, Jerome O Klein, Christopher B Wilson, Carol J Baker. Published by Elsevier, Amsterdam, 2006, £184.00 (hardback), pp 1313. ISBN 0-7216-0537-0


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Reducing perinatal and neonatal mortality and later morbidity is one of the main aims of both obstetricians and neonatologists. In the developed world, public health initiatives such as childhood vaccination have helped to reduce the effect of infectious disease on both fetal and neonatal death and long-term morbidity. However, worldwide infectious disease still takes a major toll on pregnant women, their fetuses and children. Indeed, it has been estimated that 30–40% of neonatal deaths worldwide (totalling 4 035 000 in 2001 according to WHO) are associated with infectious disease. Even in the developed world, there remain considerable challenges for the obstetrician and neonatologist in the management of infectious disease during pregnancy and in the newborn. Increased mobility between countries, the plight of refugees and asylum-seekers, HIV and drug-resistant pathogens may pose particular challenges for healthcare professionals.

It is against such a backdrop that the latest edition of this reference text is published. The book is divided into four sections. The opening section contains chapters on: key concepts in the pathogenesis of infectious disease in the fetus and newborn; the global burden of infectious disease in pregnancy and the newborn; obstetric factors associated with fetal and neonatal infection; fetal and neonatal immunology; and a chapter on human milk.

The second section deals with bacterial diseases. Chapters on the bacterial causes of systemic and multisystem disease follow, together with detailed specific chapters on the role of specific bacteria (such as chlamydia, gonococcus, mycoplasma, tuberculosis and group B streptococcus) in fetal and neonatal infection in body systems. These specific chapters will be of particular interest to obstetricians and neonatalogists, but also provide excellent reference sources for the family doctor and the microbiologist.

A third section on viral diseases includes chapters on HIV, hepatitis, parvovirus and cytomegalovirus among others. Smallpox and vaccinia also receive coverage (albeit briefer). The fourth section covers protozoal, helminth and fungal infections, with specific chapters on toxoplasmosis, candidiasis and less common infections, such as Pneumocystispneumonia, that may become of increasing importance in the light of HIV and AIDS. These pathogen-specific chapters provide an excellent and fully referenced resource for obstetricians and neonatalogists faced with an unfamiliar problem.

The fifth and final section of the book deals with the epidemiology of hospital acquired infections in the neonatal unit, their prevention and control; a chapter on laboratory testing in suspected neonatal sepsis and one related to the clinical pharmacology of antimicrobials—both in pregnancy and in the neonate—conclude the book.

Although clinicians will also want to refer to their own hospital, college or professional body’s guidelines on the investigation and management of infection in the fetus or neonate, this extensively referenced textbook will be of great help to those charged with updating their own unit’s guidelines. It will also serve as a valuable day-to-day source of information for obstetricians, midwives and neonatologists, whether working in the community, maternity hospital or neonatal unit.