A variety of congenital viral infections are responsible for a large p
roportion of the mortality and morbidity in infancy and childhood. Ver
tical transmission may occur during primary maternal infection or duri
ng chronic or recurrent infection, with different implications for cou
nselling and testing in pregnancy. Strategies for the diagnosis and pr
evention of mother-to-child transmission differ according to the timin
g and mechanisms involved, As demonstrated by hepatitis B research in
the past and human immunodeficiency virus today, multicenter cohort st
udies and clinical trials are a key to developing effective interventi
ons. (C) 1998 Rapid Science Ltd.