Impact of infectious diseases on maternal and neonatal outcomes in clinical and community settings

Infectious diseases continue to be a major cause of poor maternal and neonatal health outcomes worldwide, affecting both high-income and low- and middle-income countries. Despite advances in antenatal care, antibiotics, and public health systems, infections during pregnancy still contribute significantly to maternal deaths, preterm birth, low birth weight, neonatal sepsis, and long-term developmental complications. This narrative review examines recent evidence on how infectious diseases affect maternal and neonatal health across both clinical and community settings. The review explores infections such as COVID-19, HIV, malaria, syphilis, and chorioamnionitis to show how disease-specific factors interact with broader social conditions, healthcare systems, and structural inequalities to shape outcomes. Five major themes emerge from the literature: the global burden of maternal and neonatal infections; the clinical effects and mechanisms of specific pathogens; socioeconomic and structural factors that increase vulnerability; health system issues such as infection surveillance, antimicrobial stewardship, and quality of care; and behavioral and psychosocial influences on infection risk and treatment outcomes. The findings highlight that no single intervention is sufficient to reduce the burden of infectious diseases in pregnancy. Clinical care alone cannot fully address these challenges without strong health systems, effective surveillance, community engagement, and broader structural improvements. Overall, the evidence supports integrated, multi-level approaches as essential for reducing preventable maternal and neonatal illness and death worldwide.