Listeriosis in Pregnancy: A Review

Importance Listeriosis is a rare foodborne condition that can cause serious health consequences in neonates and pregnant women. Listeria monocytogenes can be vertically transmitted to the fetus, resulting in adverse maternal, fetal, and neonatal outcomes. In this review, we summarize what is currently known about listeriosis in pregnancy and review the current management and treatment recommendations. Objective To summarize the clinical and relevant evidence available regarding listeriosis in pregnancy and educate providers on common clinical symptoms, sequelae, and appropriate treatment guidelines. Evidence Acquisition A PubMed review was conducted using search terms "pregnancy" OR "Listeria" OR "Maternal Listeriosis," and "Neonatal Listeriosis." The search included review articles, original research articles, and guidelines on diagnosis and management of listeriosis in pregnancy. The search was limited to the English language and publications between 1988 and July 2018. Conclusions Listeriosis in pregnancy can result in severe adverse maternal, fetal, and neonatal outcomes including miscarriage, preterm labor, fetal death, and neonatal meningitis and sepsis. Early treatment has been shown to improve fetal and neonatal outcomes; therefore, prevention with education and early diagnosis prompting treatment will improve overall outcomes. Relevance The incidence of listeriosis is expected to rise in the coming years due to changes in the US population, with increasing numbers of older Americans and Hispanic individuals, both of whom are at higher risk. Pregnant women contract listeriosis at a rate that is 16- to 18-fold greater than the general population. Given the expected increased rise in incidence and increased susceptibility of pregnant women, understanding the common clinical symptoms, maternal and fetal sequelae, and appropriate treatment guidelines is essential. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to counsel patients in the preconception and antenatal period regarding listeriosis in pregnancy; identify potential risk factors and clinical signs and symptoms concerning for maternal listeriosis; and propose an antibiotic regimen for suspected exposure or confirmed diagnosis of Listeria in pregnancy.