Available online 11 October 2023, 151841

Author links open overlay panel, Abstract

Vector-borne diseases (VBDs) are caused by infectious pathogens that spread from an infected human or animal reservoir to an uninfected human via a vector (mosquito, tick, rodent, others) and remain an important cause of morbidity and mortality worldwide. Pregnant individuals and their fetuses are especially at risk, as certain pathogens, such as Zika virus, have specific implications in pregnancy and for neonatal health. Global climate change is affecting the incidence and geographic spread of many VBDs. Thus, it is important for clinicians in the fields of obstetrics/gynecology and newborn medicine, regardless of geographic location, to familiarize themselves with a basic understanding of these conditions and how climate change is altering their distributions. In this chapter, we review the incidence, clinical presentation, implications during pregnancy and intersection with climate change for four of the most important VBDs in pregnancy: malaria, Zika, dengue and Chagas disease. Although not exhaustive of all VBDs, a more extensive table is included for reference, and our discussion provides a helpful framework for understanding other vector-borne pathogens and perinatal health.

Section snippetsBackground

Vector-borne diseases (VBDs) are infectious pathogens that are transmitted from animal reservoirs to humans through an intermediary organism (the vector), usually an arthropod such as a mosquito, flea, tick, or rodent. Pathogens carried by vectors can be viruses, bacteria, or parasites (Box 1). The history of humanity is defined by VBDs; some pathogens, such as malaria, have afflicted populations since the beginnings of modern agriculture more than 10,000 years ago, while others, such as Zika

Global Climate Change and Vector Borne Disease

Human activity has contributed to an increase in global temperatures, leading to changes in sea levels, weather patterns, local ecospheres, and ultimately to changes in the distribution of bacteria, viruses, parasites and the vectors which transmit them..4 How climate change impacts vector ecology is complex and alterations in VBD incidence will not be uniform across the globe.5

Increasing global temperatures may increase the range and abundance of both vectors as well as their animal reservoirs

Overview of Key Vector Borne Diseases in Pregnancy

Pregnancy is a time of unique physiologic and immune adaptation that puts pregnant individuals at particular risk for acquiring certain VBDs or, in some instances, suffering more severe consequences of the disease. Pregnant women have higher respiratory rates and consequently exhale more carbon dioxide compared to nonpregnant individuals. Carbon dioxide is a chemoattractant to mosquitos and possibly other insects. Similarly, blood flow to the skin is increased, and therefore pregnant

Disparities in the Distribution of Vector Borne Diseases

A discussion about VBDs is inseparable from a broader discussion about poverty, inequality, and injustice. Ninety percent of VBD infections occur in Africa and South-East Asia, and 96% of infections occur in low- and middle-income countries.2,34 Even within high-income countries, poor and marginalized communities are at greater risk from VBDs secondary to unequal exposure to mosquitos and from differential effects of climate change on distinct demographic groups.67 Due to differences in

Summary

Anthropogenic climate change is impacting the incidence of and geographic distribution of VBDs, many with particular relevance to pregnancy. The impacts will vary regionally, with intensification of disease in some areas, diminishment in others, and emergence in previously unaffected areas. Increased attention will be required to identify the best vector control strategies weighing the risks and benefits of vector control strategies like insecticide spraying on pregnancy outcomes. Most

Disclosures/Funding Support

None

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