Pregnant Women Hospitalized with Chikungunya Virus Infection, Colombia, 2015

Escobar, María Fernanda; NIETO, A.L. SOLANO; Loaiza-Osorio, Sara; Barona, Juan Sebastián; Rosso, Fernando

doi:10.3201/eid2311.170480

Cited by 33 publications

(50 citation statements)

References 34 publications

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“…Of the 563 identified articles, 13 [ 27 , 45 – 56 ] (from 8 cohorts) with pertinent data were included in the quantitative data synthesis ( Fig 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…By extrapolation also of these data [ 27 , 51 , 55 ], the overall pooled-MTCT-risk across cohorts was at least 15.5% (95% CIs: 13.57%-17.53%; 206/1331) ( Table 1 ; S3 and S4 Tables) and the risk among maternal infections during the intrapartum period was at least 50.0% (95% CIs: 34.90%-65.10%; 23/46) vs 0% (0/712) among antepartum/peripartum maternal infections. The timing of maternal infections was analyzed only in three cohorts [ 27 , 53 , 56 ]; 5% of all analyzed maternal infections in these three cohorts occurred during the intrapartum period. Results by REM synthesis of data were similar (MTCT-overall risk: at least 12.6% [95% CIs 4.47%-20.77%]; MTCT-risk-intrapartum infections: at least 50.3% [3.75%-96.93%]).…”

Section: Resultsmentioning

confidence: 99%

“…However, this risk was 50.0% (95% CIs: 34.90%-65.10%; 23/46) among intrapartum maternal infections vs 0% (0/758) among antepartum/peripartum maternal infections. Only three maternal-fetal cohorts (La Reunion[ 27 ], ShriLanka [ 53 ] and Colombian cohort[ 56 ]) analyzed their data according to the timing of maternal infection and the reported risks for symptomatic neonatal disease from intrapartum paternal infections across these three cohorts were 48.7% (19/39) [ 27 ], 100% (4/4) [ 53 ] and 0% (0/3) [ 56 ] respectively. The reported cases of symptomatic neonatal disease were almost exclusively from intrapartum maternal infections.…”

Section: Resultsmentioning

confidence: 99%

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Mother-to-child transmission of Chikungunya virus: A systematic review and meta-analysis

Contopoulos‐Ioannidis

Newman-Lindsay

Chow

et al. 2018

PLoS Negl Trop Dis

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BackgroundChikungunya virus (CHIKV) is an emerging arboviral infection with a global distribution and may cause fetal and neonatal infections after maternal CHIKV-infections during gestation.MethodologyWe performed a systematic review to evaluate the risk for: a) mother-to-child transmission (MTCT), b) antepartum fetal deaths (APFD), c) symptomatic neonatal disease, and d) neonatal deaths from maternal CHIKV-infections during gestation. We also recorded the neonatal clinical manifestations after such maternal infections (qualitative data synthesis). We searched PubMed (last search 3/2017) for articles, of any study design, with any of the above outcomes. We calculated the overall risk of MTCT, APFDs and risk of symptomatic neonatal disease by simple pooling. For endpoints with ≥5 events in more than one study, we also synthesized the data by random-effect-model (REM) meta-analysis.Principal findingsAmong 563 identified articles, 13 articles from 8 cohorts were included in the quantitative data synthesis and 33 articles in the qualitative data synthesis. Most cohorts reported data only on symptomatic rather than on all neonatal infections. By extrapolation also of these data, the overall pooled-MTCT-risk across cohorts was at least 15.5% (206/1331), (12.6% by REMs). The pooled APFD-risk was 1.7% (20/1203); while the risk of CHIKV-confirmed-APFDs was 0.3% (3/1203). Overall, the pooled-risk of symptomatic neonatal disease was 15.3% (203/1331), (11.9% by REMs). The pooled risk of symptomatic disease was 50.0% (23/46) among intrapartum vs 0% (0/712) among antepartum/peripartum maternal infections. Infected newborns, from maternal infections during gestation were either asymptomatic or presented within their first week of life, but not at birth, with fever, irritability, hyperalgesia, diffuse limb edema, rashes and occasionally sepsis-like illness and meningoencephalitis. The pooled-risk of neonatal death was 0.6% (5/832) among maternal infections and 2.8% (5/182) among neonatal infections; long-term neurodevelopmental delays occurred in 50% of symptomatic neonatal infections.Conclusions/SignificancePublished cohorts with data on the risk to the fetus and/or newborn from maternal CHIKV-infections during gestation were sparse compared to the number of recently reported CHIKV-infection outbreaks worldwide; however perinatal infections do occur, at high rates during intrapartum period, and can be related to neonatal death and long-term disabilities.

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“…Of the 563 identified articles, 13 [ 27 , 45 – 56 ] (from 8 cohorts) with pertinent data were included in the quantitative data synthesis ( Fig 1 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Mother-to-child transmission of Chikungunya virus: A systematic review and meta-analysis

Contopoulos‐Ioannidis

Newman-Lindsay

Chow

et al. 2018

PLoS Negl Trop Dis

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show abstract

“…6 Escobar et al, reported clinical manifestations of neonatal chikungunya including fever, irritability, rash and hyperalgesia syndrome. 7 Diffuse limb edema, meningoencephalitis and bullous dermatitis were other rare manifestations. Encephalopathy in neonates has been associated with chikungunya virus as well as zika virus infections.…”

Section: Discussionmentioning

confidence: 99%

Self limiting fetal bradycardia associated with maternal evidence of dengue and chikungunya virus co-infection: a case report

Goel

Narain

Goel

2019

Int J Reprod Contracept Obstet Gynecol

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Dengue and chikungunya infections are commonly encountered by the clinicians in a tropical country like India. We report this case to emphasize the rare manifestations of self-limiting intrapartum bradycardia in fetuses of chikungunya and dengue infected mothers. A primigravida at 32 weeks of gestation presented with history of fever for one day. The blood investigations were positive for both dengue and chikungunya virus infection. On the third day of fever, NST showed a low baseline fetal heart rate of 95 to 100 beats per minute but good beat to beat variability and three accelerations in 10 minutes. This pattern persisted for 48 hours. Although, the finding initially appeared alarming, the change in baseline heart rate of fetus was transient and self-limiting and recovered completely. Hence, a judicious approach and close fetal surveillance can avoid hasty decisions regarding an early termination of pregnancy.

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“…In Argentina, the transmitting mosquito Aedes albopictus was restricted to the northeastern province of Misiones, while the A. aegypti was present from the northern border to the Patagonian city of Neuquén 5 . In this same period, in Colombia, CHIKV infection was an important complication observed in pregnant women, leading to admission to intensive care due to sepsis 8 .…”

mentioning

confidence: 99%

Clinical profile and factors associated with hospitalization during a Chikungunya epidemic in Ceará, Brazil

Pinto

Silva

Mota

et al. 2019

Rev. Soc. Bras. Med. Trop.

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Introduction: The aim of this study was to characterize the clinical-epidemiological profile of Chikungunya virus infection and the factors associated with hospitalization during the peak of the most recent epidemic period in Brazil (2016-2017). Methods: Two official databases of the State Health Secretariat of Ceará were used, and a total of 182,731 notifications were analyzed. Results: Independent factors associated with hospital admission were chronic kidney disease (OR 4.56, 95% CI 3.36-6.17), hypertension (OR 1.90, 95% CI 1.69-2.14), leukopenia (OR 1.89, 95% CI 1.56-2.30) and diabetes mellitus (OR 1.70, 95% CI 1.44-1.99). Conclusions: The pre-existing comorbidities have shown the potential to destabilize the patients' clinical status.

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Pregnant Women Hospitalized with Chikungunya Virus Infection, Colombia, 2015

Abstract: Personnel in charge of obstetric populations should watch for cases of chikungunya virus‒induced sepsis with hypoperfusion and organ dysfunction.

Cited by 33 publications

References 34 publications

Mother-to-child transmission of Chikungunya virus: A systematic review and meta-analysis

Mother-to-child transmission of Chikungunya virus: A systematic review and meta-analysis

Self limiting fetal bradycardia associated with maternal evidence of dengue and chikungunya virus co-infection: a case report

Clinical profile and factors associated with hospitalization during a Chikungunya epidemic in Ceará, Brazil

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