What Is TORCH Syndrome?

Written by Deanna Altomara
Medically Reviewed by Zilpah Sheikh, MD on March 31, 2025
11 min read

The letters in TORCH stand for different types of infections:

  • Toxoplasmosis
  • Other agents (such as HIV, syphilis, varicella, and fifth disease)
  • Rubella
  • Cytomegalovirus
  • Herpes simplex

TORCH syndrome may sound like one medical condition. But it’s actually a group of different infections. They're caused by tiny germs like bacteria, viruses, or parasites. The germs (pathogens) can potentially cause serious problems for your unborn baby or newborn. 

TORCH germs can infect you, your growing baby (fetus), or your newborn. 

“While it can be worrisome for patients who may be at risk for such infections, it’s important to remember that most maternal infections do not result in fetal infection,” says Elise Rosenthal, MD, a maternal-fetal medicine specialist in the Department of Obstetrics and Gynecology at New York University Grossman School of Medicine in New York.

There are three ways babies can get TORCH infections:

Through your placenta. Your baby can get germs from the placenta — an organ in your womb (uterus) which supplies nutrients and oxygen to your baby.

At birth. The germs in your birth canal can sometimes infect your baby when they pass through it during birth.

Breastfeeding (chestfeeding). Some germs can get in your breastmilk and infect your baby when they drink it.

Your growing baby in your uterus can’t fight off infections as well as an adult. Their immune system is still growing, too. If infected, the germs can cause some organs to form abnormally. What the infection is and how mature your baby is can affect your baby's symptoms.

Some types of TORCH infections are more common in certain parts of the world. It can depend on things such as your climate, where you live, or your environment. Here are some common ones:

Toxoplasmosis

Toxoplasmosis is an infection caused by a parasite called Toxoplasma gondii. It can get into your body through your mouth. 

The parasite can get in the soil, water, or on produce (veggies). You can get it from undercooked meat or shellfish, too. It can also infect you from unpasteurized raw goat milk or cat feces (poop). 

A review reports that infection is rare, occurring in only 0.2 out of every 1,000 pregnancies in the U.S.

Other agents

The other infectious agents typically include:

HIV. It’s very rare in children younger than 13. During 2018, only 65 children had it in the U.S. If you have HIV, your doctor will test your viral load. That's the number of viruses in your blood. 

If it’s less than 1,000 copies per milliliter (mL), your baby’s infection risk is very low. After your baby is born, HIV might not show up for more than six months. 

With treatment, your baby’s risk for HIV is less than 1% in the U.S. Your doctor can discuss your risk of chestfeeding, too. A higher viral load can mean a higher risk.

Fifth disease. It was the fifth infection-causing germ on a list — so parvovirus B19 is called the fifth disease. Because most adults have had it, infection rarely happens in babies. And it only happens in about 1 out of every 400 pregnancies.

Syphilis. It’s a sexually transmitted disease (STD) caused by the bacteria Treponema pallidum. It can cause serious problems as your baby grows. But treatment can help improve you and your baby’s health.

Varicella. Varicella zoster virus causes chickenpox. Because many adults have had it, babies usually don't get infected. 

Rarely, it can cause congenital varicella syndrome if you’re infected less than 27 weeks into pregnancy. About 0.4 to 2 out of every 100 babies get it.

Neonatal varicella can cause life-threatening problems. It happens to 7 out of every 100 babies. But treatments can help you and your baby get better.

Rubella

It's called German measles, but it’s actually an upper respiratory virus. If you’re infected before 12 weeks of pregnancy, your baby can have life-threatening problems. In fact, rubella causes most problems during the first three months of your baby's growth in your womb. 

But infection is very rare. Less than 10 cases happen in the U.S. each year. That’s because most people get the measles-mumps-rubella (MMR) vaccine. And fewer than five babies a year are born with congenital rubella syndrome. 

Cytomegalovirus

The cytomegalovirus (CMV) spreads through your saliva and urine, especially in children. It also spreads through sexual contact, breast milk, or organ transplants. 

CMV is the most common TORCH infection. More than half of U.S. adults have been infected. It can cause congenital CMV in babies.

Herpes simplex

Herpes simplex virus (HSV) is a common, lifelong STD. It's caused by two different types of viruses:

  • HSV-1 can cause blisters around your mouth but can also affect your genitals. 
  • HSV-2 can cause oral herpes and blisters or open sores on your genitals or anus (genital herpes).

About 20 to 25 in every 100 pregnancies have genital herpes. But the risk of your baby getting neonatal herpes is very low. Your baby’s risk is highest if you: 

  • Get your first outbreak when you're pregnant.

  • Have an outbreak during or right after delivery.

Screening for TORCH infections can depend on your risk, where you live, and the type of infection.

Toxoplasmosis screening.It’s not a routine screening test in the U.S. because your infection risk is very low. If you’re around cats or at risk, your doctor may do a blood test. A positive result for IgG and IgM or IgA can mean you may have it.

Your immune system makes immunoglobulins (Ig) grouped as A, G, and M. These antibodies help fight off toxoplasma infection. Your doctor will likely repeat your test, checking for rising antibody levels. They may do a PCR test to look for toxoplasmaDNA, too.

Screening for other agents. You’ll get a blood test for HIV and syphilis. If you’re at higher risk, your doctor may repeat your HIV screen before 36 weeks of pregnancy.

And your doctor will repeat your syphilis testing at 28 weeks of pregnancy and at delivery if you're at risk. You’ll get one of two tests. Your doctor may use a non-treponemal test. It checks for cell damage caused by syphilis. 

Your doctor may also do a treponemal test. It looks for Treponema pallidum antibodies. A positive treponemal test means they’ll repeat it before deciding on treatment.

Routine screening isn’t suggested for parvovirus B19 or varicella zoster virus. But if you show signs of fifth disease, you’ll get a blood test. If you get infected or your baby has neonatal varicella, the test tells your doctor if the treatment can work.

Rubella screening. You’ll likely get a blood test if you’re infected or to confirm congenital rubella syndrome. Although routine screening isn’t done because most people are immune.

CMV screening. If you have symptoms, you’ll get a blood test for CMV. But your doctor tests your baby's urine and saliva within the first 2 to 3 weeks after birth, if needed.

Herpes screening. Your doctor will monitor your pregnancy if you have herpes. They’ll check you and ask about outbreaks closer to delivery. Because you had herpes, your antibodies pass through the placenta to protect your baby from infection. 

Other tests. Your doctor may order more testing for you and your baby, including:

  • Viral cultures test your fluid or tissue for viruses (such as saliva, mucus, blood, urine, amniotic fluid, or fluid from an infected sore).
  • PCR tests check your fluid for viral DNA or RNA.
  • Imaging scans like ultrasound, CT, or MRI may be used to diagnose problems with your unborn baby.

Your TORCH treatment can depend on the type of germ making you sick. It also matters how serious your symptoms are and when you got sick. Depending on your health, you might need medication like antibiotics, antiparasitics, or antivirals.

Sometimes, your doctor will just track your healing progress. Your baby may need medicine. After birth, your baby may need care in the neonatal intensive care unit (NICU). Ask your doctor if you can safely chestfeed without passing on the infection.

Toxoplasmosis treatment. Most babies born with toxoplasmosis have no symptoms. But your doctor will likely give them an antiparasitic medicine to kill the parasite. Your baby’s doctor may use pyrimethamine plus sulfadiazine along with folinic acid.

Treatments for other agents. If you have HIV and are pregnant or planning to get pregnant, antiretroviral therapy (ART) can help. It also lowers your baby's infection risk. 

Babies born with HIV can get ART, too. If you stay on ART and give your baby treatment for 2 to 6 weeks after birth, their risk for HIV is 1 in 100.

Among those infected with parvovirus B19 during pregnancy, only 5 in 100 babies experience problems. Your doctor will watch your baby for anemia (low blood count) and provide treatment. 

If you’re pregnant and test positive for syphilis, your doctor can give you antibiotics. Benzathine penicillin G can also help prevent syphilis from infecting your baby.

If you get chickenpox, you’ll likely get antiviral medicine. It may help make the problems milder for your unborn baby. Treatment with varicella-zoster immune globulin (VariZIG) can help prevent neonatal varicella.

Rubella treatment. Although there’s no specific cure for rubella, your doctor will monitor you closely. You or your baby may get serious symptoms, like anemia (low blood count), requiring treatment.

CMV treatment. Antiviral medicines, such as valganciclovir, can treat babies. Some studies say it can help your baby's hearing and growth problems.

Herpes treatment. If infected after 28 weeks of pregnancy, your doctor may give you an antiviral. But if your baby has neonatal herpes, they’ll likely get antiviral medicine after they’re born.

You can chestfeed while your baby gets it — unless you have herpes on your nipples. Talk to your doctor about what’s best.

Serious problems can happen from TORCH infections as your baby grows in the womb. These germs can harm your baby’s growth pattern. 

“The timing of infection during pregnancy plays a major role in the severity of complications,” says Rosenthal. Some infections can cause fetal organ problems during key stages of growth. But many are preventable or treatable.

 “Even when [infection] occurs, not all fetuses develop complications,” says Rosenthal "And not all babies have problems."

Toxoplasmosis complications. If you get toxoplasmosis during pregnancy, your miscarriage risk is 1.3% to 1.6%. Here are a few ways to lower your risk:

  • Avoid raw eggs.
  • Cook your meat to an internal temperature of 152 F.
  • Don’t eat raw shellfish.
  • Wash your hands or produce after touching soil.
  • Avoid cat litter and feces (poop).
  • Avoid travel to places with higher rates of infection.
  • Don’t drink unfiltered water (like lakes or streams).

Complications caused by other agents. Without treatment, almost half the babies with HIV can die before 2 years of age. When infected, HIV can cause delayed growth, pneumonia, or swollen lymph nodes and belly (abdomen). 

But if you and your baby take ART medicine, you can lower your risk of infection to less than 1%. And you and your baby can get better.

Syphilis may not cause any symptoms in your baby at first. But congenital syphilis has increased in recent years. 

About 1 out of every 1,300 babies get it. They can get bone issues, anemia, meningitis, skin rashes, or nerve problems. Some babies have blindness or deafness, too. 

Almost half of unborn babies with syphilis can be lost (miscarriage), stillborn, or die shortly after birth. 

Here are a few ways to lower your syphilis risk:

  • Stay in a long-term relationship with one partner, both testing negative for syphilis.
  • Before pregnancy, get tested and treated for syphilis, if needed.
  • Use condoms every time you have sex.

Fifth disease can cause serious anemia (low blood count) in your baby. Less than 5% of the time, parvovirus B19 can cause miscarriage. 

To prevent infection, practice good hygiene: 

  • Wash your hands

  • Cover your mouth when you sneeze or cough

  • Clean frequently touched surfaces in your house

Varicella zoster virus is rare. Babies with congenital varicella can have:

  • Scarring on their skin

  • Low birth weight

  • Stomach problems

  • Arm and leg issues 

  • Brain problems

  • Eye problems 

Neonatal varicella can cause life-threatening symptoms, such as pneumonia, seizures, and lifelong problems.

Here are some ways to prevent infection:

  • At least a month before getting pregnant, get vaccinated — if you’ve never had it.
  • If you think you’ve been exposed or have it, tell your doctor right away.

Rubella complications. During pregnancy, infection can cause loss (miscarriage), stillbirth, or a low birth weight. Rarely, congenital rubella syndrome can cause life-threatening heart, vision, brain, liver, spleen, or bone marrow problems. Only about 15 babies had it between 2005 to 2018.

Although there isn’t a cure, you can prevent infection with the MMR vaccine.

CMV complications. Of the 1 in 200 babies born with congenital CMV, only 1 in 5 will get long-term symptoms. Serious symptoms can include: 

  • Hearing loss

  • Lung issues

  • Brain problems 

  • Liver and spleen problems

  • Low birth weight 

Although there’s no vaccine, you can lower your risk. Avoid contact with saliva (spit) and urine (pee) from babies and children. Don’t share food, utensils, or cups with them. And wash your hands each time you change diapers, too.

Herpes complications. Neonatal herpes can rarely cause pregnancy loss, skin, bone, eye, and brain problems. But less than 0.1% of babies get it in the U.S. Your baby’s risk for infection is 30% to 50% at birth if you’re infected after 28 weeks. 

If you think you’ve been exposed, tell your doctor right away. But if you have it or get infected before 28 weeks, your baby’s risk is very low, less than 1%. To lower your baby’s risk, take these steps:

  • Tell your doctor about your herpes or signs of an outbreak — tingling, itching, or pain.
  • Discuss having a C-section.
  • Ask about not breaking your bag of waters, using a fetal scalp monitor, vacuum, or forceps.
  • If your partner has herpes, avoid oral, vaginal, or anal sex after 28 weeks.

“But of course, the best treatment is prevention,” says Rosenthal. “Prevention strategies — such as vaccination, hygiene measures, and prenatal screening — remain some of our best tools in reducing the impact of these infections on developing fetuses.”

Toxoplasmosis, other agents, rubella, cytomegalovirus, and herpes simplex (TORCH) infections can cause serious or life-threatening problems for you and your unborn baby. The best treatment is prevention for you and your unborn baby. Talk to your doctor about vaccination, hygiene, and prenatal screening.

How common are TORCH infections?

TORCH infections cause 2% to 3% of medical problems that babies have at birth (congenital).

Can TORCH infection cause a miscarriage?

Sometimes, TORCH infections can cause premature birth, miscarriage, or stillbirth. It depends on the germ, when you get infected, and how early you get treated.

What is TORCH infection IgG positive?

IgG refers to immunoglobulin G, a type of antibody your immune system makes to fight off germs. Your immune system makes the most of this type to protect you from infection. And your IgG levels rise after being vaccinated, too.

A positive IgG blood test means you’re immune to a certain type of germ (virus, bacteria, or parasite). Your doctor may also repeat the test. If it shows rising IgG levels, you may have been recently infected.