Poliovirus
Poliovirus infection in pregnancy can result in abortion, stillbirth, neonatal disease, or no evidence of fetal involvement.? Maternal poliomyelitis in late pregnancy has resulted intransplacental transmission of the virus.? There has never been a search for the transplacental passage of attenuated poliovirus vaccines

Coxsackievirus
Evidences of intrauterine infection has been presented for coxsackieviruses A4 and B2 to B6 in humans and A1 A8 A9, B1 to B4 in animals. ?In 1956, Benirschke et al reported the first case of intrauterine infection with a coxsackievirus B3---- the infant was delivered by cesarean section and had clinical evidence of infection several hours after birth
Brightman et al. recovered coxsackieviruses B5 from placenta rectum of a premature infant.
Burch et al. presented immunofluorescent studies of 3 fetuses of5-6 months gestational age----- the 6-month-old fetus had coxsackievirus B4 myocarditis; one fetus of 5-month-old had coxsackievirus B3 infection; the other 5-month-old fetus had coxsackievirus B2,B3,B4 infection
Basso et al. recovered coxsackievirus from placenta, liver and brain of a fetus following a spontaneous abortion at 3 months of gestation

Echovirus
Less is known about transplacental passage of echovirus than about that of poliovirus and coxsackievirus.? Echovirus infections are regular occurences in all populations,so women in all stages of prgnancy are frequently infected.
Cherry et al. cultured samples from 590 newborn infants during a period of enteroviral prevalence without isolating an echovirus ; ?antepartum serologic study of agroup of 55 mothers showed 5 were actively infected with echovirus 17 during 6 week-period before delivery
Berkovich et al. noted a newborn without clinical illness who had Ig M echovirus 22 antibody in the cord blood.
Hughes reported a newborn with echovirus 14 infection who had markedly elevated IgM on the 6th day of life.
Echovirus 7,9,11,19,27 and 33 have also been noted in transplacentally acquired infections.
Ascending infection and contact infection during birth.
There is no evidence for either ascending infection or contact infection with enterovirus during birth.
Inprospective studies of genital HSV and CMV infections, there have been no enteroviral isolation.
Reyes et al. recovered coxsackievirus from B5 from the cervix of four 3rd trimester pregnant women; all the infants were healthy
Reyes reported a newborn who died from echovirus 11 infection; the illness had its onset on the 3rd day of life, and the virus was recovered from the mother's cervix.
The fecal carriage rate of enterovirus in asymptomatic adult varies between 0 and 6 percent ; enteroviral infection during the birth process would seem probable.
Clinical manifestation
Abortion
Poliovirus
Poliomyelitis is associated with an increased incidence of abortion
Abortion was related to the severity of maternal illness, including the degree of fever.
Horn noted 43 abortions in 325 pregnancies complicated by maternal poliomyelitis
Schaeffer et al. studied the placenta and abortus 12 days after the onset illness in the mother; Poliovirus type 1 was isolated from both the placenta the fetal tissues
In a study of 310 pregnant women who received trivalent oral polioviral vaccine, there was no increase in abortions above the expected rate
Coxsackievirus
There is no available evidence that suggests that coxsackievirus infection in pregnancy result in abortion
Echovirus
There is no available evidence that suggests that echovirus infections during pregnancy are a cause of spontaneous abortion
Landsman et al. studies 2631 pregnancies during an epidemic of echovirus 9 and could find no difference in antibody to echovirus 9 in mothers who aborted and in those who delivered term infants
Congenital malformations
Poliovirus
The congenital malformation rate as determined in the Collaborative
Perinatal Research Study of 45,000 pregnancies was 4.1 percent
Isolated instances of congenital malformation and maternal poliomyelitis have been noted
Kaye et al. noted 6 anomalies in 101 infants born to mothers with poliomyelitis during pregnancy
In the reviews of Horn, Bates, and Greenberg, no evidence of maternal polioviral infection-induced anomalies was noted.
Prem et al studied the infants of 69 women who received attenuated vaccine before 12th weeks of gestation and found no anomalies
It was noted in Blackburn, England, that the rate of congenital defects increased coincident with mass vaccination with trivalent poliomyelitis vaccine
A mass vaccination program with live poliovirus vaccine was carried out in finland; there was no evidence that vaccine virus had harmful effect on developing fetuses
Coxsackievirus
There is the possibility of an association between congenital infections with coxs ackievirus B and severe CNS defects
Gauntt et al. studied the ventricular fluids from 28 infants with severe congenital anatomic defects of CNS; in 4 infants antibody to one or more coxsackievirus type was found in the fluid
In a large prospective study by Brown et al., serum samples from 630 mothers of infants with anomalies and 1164 others of children without defects were studied and serologic evidence of infection during the first trimester and last 6 months of pregnancy with coxsackievirus B1 to B5 and A9 and with echovirus 6 and 9 was sought
The authors demonstrated a positive correlation between maternal infection and infant anomaly with coxsackievirus B2 to B4 and A 9
When coxsackievirus B were analyzed as a group (B1 to B5), there was an overall association with congenital heart disease.
Coxsackie A9 were associated digestive anomalies
There was no correlation between reported maternal illness and serologic evidence of infection with the selected enterovirus----- this suggests that many infections related to the anomalies were asymptomatic
Echovirus
In the large prospective study of Brown et al., maternal infection with echovirus 6 and 9 was not associated with any anomaly
In three other studies, no association between maternal echovirus 9 infection and congenital malformation was noted
Prematurity and stillbirth
Poliovirus
In a study by Horn of 325 pregnancies, 9 infants died in utero; in each instance, the mother was critically ill with poliomyelitis
Siegel et al. noted an increase in prematurity after maternal poliomyelitis infection
There has been no observation of stillbirth or prematurity in relation to vaccine administration
Coxsackievirus
Bates reported a fetus of 8 months' gestational age being stillborn had coxsackievirus B3 antigen in the myocardium on fluorescent antibody study
Burch et al. reported 3 sillborn infants who had fluorescent antibody evidence of coxsackievirus B myocarditis (B2, B3 and B4)
A macerated infant was delivered 2 weeks after the occurrence of coxsackievirus A9 meningitis in a 27-year-old women
Coxsackievirus B6 was recovered from the brain, liver and placenta of a stillborn infants
Echovirus
Echovirus 27 has been associated with intrauterine death on 2 occasions
Piraino et al. noted that 12 of 19 still stillbirths occurred from July through October in coincidence with a major outbreak of enteroviral disease; Echovirus 11 was the major agent isolated during this period