Perinatal Infections. Ciba Foundation Symposium 77

Perinatology is the medical discipline which involves study of the gravid female, the puerperium, and the newborn infant. The concept of perinatal infections is that to understand the pathogenesis of infections of the neonate, one must relate back to the events during pregnancy. To cover the subject well requires the input of investigators and authorities from a large number of separate disciplines. The organizers of this text have performed this service and the result brings together an interesting assortment of points of view. This book is a collection of the manuscripts prepared from a symposium on perinatal infections held in London, November 1979. There are 14 chapters, each by different authors. After each chapter the editors have included the comments from the participants at the symposium. These are well-edited and often highlight areas of controversy and add focus to the critical issues. In general the chapters have a short review of the topic or pathogen and then the bulk of the material is a review of the authors' own investigations in the area. In some areas this experience is considerable and representative of research in the field, such as in the chapter on "Natural History of Perinatal Cytomegaloviral Infection," by Charles Alford and associates; also the chapter on "Factors in the Mother/Infant Dyad that Influence the Development of Infections Before and After Birth," by Richard Naeye. This latter chapter and the one on "Placental Pathology," by William Blanc, focus on the pathologists' point of view, which is frequently forgotten in infectious disease texts. The chapter on group B streptococcal infections and on the obstetricians' viewpoint of perinatal infections are considerably less comprehensive and are covered better in other available texts for those who require a detailed overview. Because of its small size this text covers fewer topics than Remington and Klein's Infectious Diseases of the Fetus and the Newborn Infant, but it is also much less expensive, less comprehensive for the reader who wants a quick overview, and, until the new edition of Remington and Klein is published, more up to date. For the American reader it is also useful to get an international viewpoint, and this volume includes chapters by authors from Britain, France, Sweden, Switzerland, Greece, Ethiopia, South Africa, Costa Rica, Guatemala, and the USA. The different priorities in terms of prevention of perinatal infections in other countries is emphasized in several of the chapters. This book would provide an excellent starting point for learning about perinatal infections for obstetricians, perinatologists, and for specialists in pediatric infectious diseases. For a truly comprehensive review of any of the specific diseases or problems, other larger and more expensive texts would have to be consulted. It would be a reasonable addition to the libraries of departments of obstetrics or pediatrics but would probably not be of much interest to generalists or specialists in other areas. ROBERT S. BALTIMORE Department of Pediatrics Yale University School ofMedicine