TORCH Infections

Overview

TORCH infections are a group of infections that can be passed from a pregnant person to the developing baby, either across the placenta during pregnancy or around the time of birth. They are grouped together because they can cause similar problems in the newborn, such as growth problems, birth defects, jaundice, and damage to the brain, eyes, or hearing.

TORCH is an acronym: Toxoplasmosis, Other infections (a varied group), Rubella, Cytomegalovirus (CMV), and Herpes simplex virus. The "other" category can include infections such as syphilis, varicella (chickenpox), and others. Recognizing these infections matters because some can be prevented, treated, or monitored during pregnancy to reduce the risk to the baby.

Symptoms

Many pregnant people have only mild or no symptoms from these infections, which is why testing and prevention are important. In the newborn, TORCH infections can cause a range of signs depending on the specific infection and its timing:

• Jaundice and an enlarged liver or spleen
• Low birth weight or poor growth
• Skin rashes or small purple spots from low platelets
• An unusually small head (microcephaly) or other brain effects
• Hearing loss, eye problems, or, in some cases, seizures

Some affected babies appear healthy at birth and develop problems such as hearing loss later, which is why follow-up is recommended for known infections.

Causes

Each TORCH infection has a different cause, but all can cross from parent to baby:

• Toxoplasmosis: a parasite spread through undercooked meat, contaminated soil, or cat feces. See toxoplasmosis.
• Other: a varied group that can include syphilis, chickenpox (varicella), and other infections.
• Rubella: a viral infection (German measles); see rubella.
• Cytomegalovirus (CMV): a common virus; see cytomegalovirus.
• Herpes simplex virus: can be passed to the baby, often around the time of delivery; see herpes.

The risk to the baby depends on which infection is involved and when during pregnancy it occurs.

Risk Factors

• Not being immune to rubella before pregnancy
• Contact with cat litter, soil, or undercooked or raw meat (toxoplasmosis)
• Close contact with young children, who commonly spread CMV
• An active or new genital herpes infection near delivery
• Limited prenatal care, which reduces chances for screening and prevention

Diagnosis

Diagnosis may involve testing the pregnant person, the baby, or both.

• Blood tests in pregnancy: some infections, such as rubella immunity and syphilis, are checked as part of routine prenatal screening.
• Targeted testing: if an infection is suspected, antibody or other blood tests can show recent or past infection.
• Newborn testing: blood, urine, or other samples can detect infection in the baby, sometimes alongside imaging of the brain.
• Follow-up evaluations: hearing and eye tests are important because some effects appear after birth.

Treatment

Treatment depends on the specific infection. Some can be treated to reduce risk to the baby, while others are managed supportively.

• Toxoplasmosis: antibiotics may be given during pregnancy and to affected newborns.
• Cytomegalovirus: antiviral medication may help some symptomatic newborns; care is otherwise supportive.
• Herpes: antiviral medicines treat the newborn and can lower the risk of transmission around delivery.
• Syphilis: treated with antibiotics in the parent and the baby.
• Rubella: no specific antiviral treatment; care is supportive, which is why prevention through vaccination before pregnancy is key.

Affected babies often need a team of specialists to monitor and support hearing, vision, and development over time.

Prevention

Prevention is central to reducing TORCH infections and their effects:

• Be up to date on rubella and chickenpox immunity before pregnancy (these live vaccines are given before, not during, pregnancy)
• Practice good hand hygiene, especially around young children, to reduce CMV exposure
• Avoid undercooked meat and wash fruits and vegetables; have someone else handle cat litter, or use gloves and wash hands, to reduce toxoplasmosis risk
• Attend all prenatal appointments for routine screening
• Tell your provider about any genital herpes history so delivery can be planned safely

When to See a Doctor

See your healthcare provider before and during pregnancy for screening and advice on preventing these infections. Contact your provider promptly during pregnancy if you have:

• A rash, fever, or flu-like illness, especially after exposure to someone who is ill
• A new or active genital herpes outbreak as delivery approaches

Seek prompt medical care for any newborn who has jaundice, poor feeding, an unusual rash, or appears unwell. A baby with seizures, difficulty breathing, or who is very hard to wake needs emergency care.

Related Topics

Frequently Asked Questions

References

1. Centers for Disease Control and Prevention (CDC). Pregnancy and infections.
2. MedlinePlus, U.S. National Library of Medicine. TORCH screen.
3. American College of Obstetricians and Gynecologists (ACOG). Infections during pregnancy.
4. National Institutes of Health (NIH). Congenital infections.