Current opinion in obstetrics & gynecology
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A variety of congenital viral infections are responsible for a large proportion of the mortality and morbidity in infancy and childhood. Vertical transmission may occur during primary maternal infection or during chronic or recurrent infection, with different implications for counselling and testing in pregnancy. Strategies for the diagnosis and prevention of mother-to-child transmission differ according to the timing and mechanisms involved. As demonstrated by hepatitis B research in the past and human immunodeficiency virus today, multicenter cohort studies and clinical trials are a key to developing effective interventions.
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The prevention of neural tube defects is a complex problem. The genetic associations may ultimately allow the prepregnancy identification of women at high risk of a neural tube defect. Education of both the public and healthcare providers has been shown to increase awareness, but the majority of women do not take folic acid before and in the early part of pregnancy. Food fortification will be effective in increasing the folate levels of the population and will have a benefit even at low doses of fortification.