Pregnancy-related listeriosis.

About one in seven cases of listeriosis occurs in pregnant women, and, although listeriosis is rare, it is the third leading cause of death from food-borne infections. Pregnancy-related listeriosis increases the risk for fetal and neonatal mortality by approximately 21%. During pregnancy, infections are more likely to occur in the third trimester (66%) than the first trimester (3%). However, fetal and neonatal adverse effects are less common as gestational age increases or with older gestational age at birth. Pregnant women seem highly susceptible in some listeriosis outbreaks making up a large percentage of cases, whereas others contain very few. Whether this results from differences in strains of L. monocytogenes, exposures, or other factors remains to be determined. Food and Agriculture Organization of United Nations/World Health Organization (FAO/WHO) estimates the human lethal dose for 50% (LD50 ) for fetal/neonatal loss is 1.9 × 106 colony forming units (CFUs) L. monocytogenes. Animal models have been developed for pregnancy-related listeriosis showing similar susceptibility and clinical outcomes as in humans. Nonhuman primate and guinea pig animal models have similar (LD50 ) values to the estimated human LD50 . Additional animal studies are needed to understand the pathways leading to fetal and neonatal listeriosis in humans. More information is needed to understand dose response, to model risk for listeriosis at lower concentrations, and to determine why some pregnant women may be more susceptible than others. To better treat listeriosis during pregnancy, biomarkers for early diagnosis of listeriosis are also needed. Last, pregnant women need to be educated about avoiding high-risk foods, like Mexican-style cheese and ready-to-eat meats. Birth Defects Research 109:324-335, 2017.© 2017 Wiley Periodicals, Inc.