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Chikungunya infection in pregnancy – reassuring maternal and perinatal outcomes: a retrospective observational study
Author(s) -
Foeller ME,
Nosrat C,
Krystosik A,
Noel T,
Gérardin P,
Cudjoe N,
MappAlexander V,
Mitchell G,
Macpherson C,
Waechter R,
LaBeaud AD
Publication year - 2021
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.16562
Subject(s) - medicine , pregnancy , placental abruption , chikungunya , obstetrics , fetal distress , retrospective cohort study , pediatrics , fetus , outbreak , surgery , virology , genetics , biology
Objective To evaluate pregnancy and neonatal outcomes, disease severity, and mother‐to‐child transmission of pregnant women with Chikungunya infection (CHIKV). Design Retrospective observational study. Setting Grenada. Population Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. Methods This descriptive study investigated 731 mother‐infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. Main outcome measures Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. Results Of 416 mother‐infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) ( P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother‐to‐child transmission occurred in two (1.3%) mother‐infant pairs and two of eight intrapartum infections (25%). Conclusion CHIKV infection during pregnancy may be protective against long‐term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother‐to‐child transmission of CHIKV. Tweetable abstract Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.