Relationship of Congenital Anomalies and Maternal Infection With Selected Enteroviruses1

The authors have analysed the frequency and structure of congenital anomalies in children born in the Pomeranian district in the period from 01.07.1997 to 31.12.1998. Among a total of 28.361 births in that area, 748 (2.64%) were affected by congenital anomalies. Among 28.361 births, 620 (2.18%) were from multiple pregnancies. 23 (3.71%) among births from multiple pregnancies were affected by congenital malformations. The prevalence rate of inborn anomalies in births from multiple pregnancy in our area were higher (3.71%) in comparison to births from singleton pregnancy (2.61%). It implies that children born from multiple pregnancy are at higher risk of developing congenital anomalies.

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“…Similar data are also given by Brown [1] and Kato and Fujiki [5]. However cardiovascular anomalies were the most common.…”

Section: Discussionsupporting

confidence: 82%

Prevalence and Forms of Congenital Anomalies in Twins Born in Pomeranian District During the Period from 1.07.1997 to 31.12.1998

Zimoń

Walczak

Fydryk

et al. 1998

Acta genet. med. gemellol.: twin res.

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“…Early reports of epidemics in maternity homes where virus was isolated from peripheral sites of neonates,2 3 were followed by studies confirming the presence of coxsackieviruses in the heart tissue of infants with myocarditis 15 Later work showed that infection during pregnancy may result in fetal damage6-8 and large scale serological studies confirmed that mothers of infants with cardiological abnormalities were more likely to be infected with coxsackievirus B than were controls 4…”

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confidence: 99%

Meta-analysis of the association of enteroviruses with human heart disease

Baboonian

Treasure

1997

Heart

157

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The role of viruses in the genesis of both dilated cardiomyopathy (DCM) and acute myocarditis remains uncertain. Modern molecular techniques such as polymerase chain reaction (PCR) and in situ hybridisation are sensitive means of detecting viral genomic material in human myocardial tissue and may help to resolve the quest. Meta-analysis of the papers in the literature records studies of both acute myocarditis and DCM where molecular techniques were used to demonstrate enteroviruses. This review studies information from the published literature as well as statistical analysis of the cumulative molecular data relating enteroviruses to DCM, and to compare these findings with the information available on the role of enteroviruses in acute myocarditis. Twelve papers reported studies in acute myocarditis, of which 11 found higher percentages of enteroviral RNA positivity in the diseased population, giving an overall odds ratio of 4.4. Seventeen papers reported studies in DCM, with 11 recording higher positivity rates in these patients. Cumulative analysis of these data suggests an overall odds ratio of 3.8. The causative role of enteroviruses in acute myocarditis, particularly in children, is supported by meta-analysis of the available literature. The data on DCM is suggestive of an association but a proportion of the studies are negative.

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“…Flamm demonstrated in rabbits that when injected intravenously Coxsackie A9 virus reached the blastocyst early and the amniotic fluid later in pregnancy.5 Such transplacental transmission is supported by the fact that maternal Coxsackie A9 infection during pregnancy results in a higher incidence of congenital malformations of the digestive tract. 6 In our patient the history suggested transplacental transmission, but since the incubation time for enteroviral disease is one to 10 days this could not be Talsma, Vegting, Hess confirmed. Generalised infection in infants usually has a fatal outcome.…”

Section: Discussionmentioning

confidence: 63%

Generalised Coxsackie A9 infection in a neonate presenting with pericarditis.

Talsma¹,

Vegting²,

Hess³

1984

Heart

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SUMMARY Coxsackie A9 virus was isolated from a neonate presenting with a massive pericardial effusion. Delivery had occurred after maternal infection. The virus was cultured from the cerebrospinal fluid, urine, and faeces of the infant and from the faeces of the mother and a sibling. Despite signs of generalised infection with pericarditis, meningitis, pneumonitis, and hepatitis, recovery was complete.Enteroviral infections in neonates are relatively common. Of the infections caused by the enterovirus group over 90% are due to echoviruses and Coxsackie B viruses and a small minority to Coxsackie A viruses. Although seldom encountered, this latter virus may cause a severe illness with a fatal outcome. Even then, cardiac involvement is rare. ' We report the case of a neonate with generalised Coxsackie A9 viral infection presenting with a massive pericardial effusion who fully recovered.Case report A 6 day old male infant was referred because of progressive cardiomegaly. The infant was born after a pregnancy of 33 weeks' gestation. The mother was 28 years old, gravida 2. In the week before delivery both the mother and a sibling had pyrexia, diarrhoea, and a transient rash on the trunk. Labour started, and after three days a male infant was born (weight 2.4 kg) despite the intravenous administration of ritodrine hydrochloride. The Apgar scores were 5 and 6 after one and five minutes respectively. Because of respiratory distress with hypercapnia and acidosis the child had to be intubated and ventilated with a high inspired oxygen content. An arterial umbilical catheter was inserted and ampicillin and gentamicin were given prophylactically. After 40 hours the infant was extubated. Because of an inspiratory stridor and possible glottal oedema dexamethasone was given intravenously. At the age of 5 days the infant's condition suddenly deteriorated. His temperature rose to 38-50C, and he had diarrhoea and a generalised rash. Sepsis was suspected and blood cultures were performed. Antibiotic treatment was changed to penicillin and chloramphenicol. On the sixth day a chest radiograph showed cardiac enlargement.On admission to this hospital the child was pink and breathing 30% oxygen. He was slightly tachypnoeic. The peripheral arterial pulses were normal, and there was no pulsus paradoxus. Systolic blood pressure in the right arm was 75 mm Hg. No murmurs were heard, and the heart sounds were clear. Hepatomegaly' was present (3 cm below the right costal margin). Neurological examination was normal and no rash was seen.The following laboratory data were obtained: white blood cell count 15 300/mm3 with 78% polymorphonuclear leucocytes and 11% band forms. Arterial blood gas analysis showed pH 7-22, Pco2 7.86 kPa (59 mm Hg), Po2 8.93 kPa (67 mm Hg), and sodium bicarbonate concentration 22 mmol/l. Electrolytes and urea and creatinine concentrations were within normal limits. Serum aspartate aminotransferase and serum alanine aminotransferase activity was normal, on admision but raised after two days (103 IU/1, and 111 IU/l resp...

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Relationship of Congenital Anomalies and Maternal Infection With Selected Enteroviruses1

Cited by 86 publications

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Prevalence and Forms of Congenital Anomalies in Twins Born in Pomeranian District During the Period from 1.07.1997 to 31.12.1998

Prevalence and Forms of Congenital Anomalies in Twins Born in Pomeranian District During the Period from 1.07.1997 to 31.12.1998

Meta-analysis of the association of enteroviruses with human heart disease

Generalised Coxsackie A9 infection in a neonate presenting with pericarditis.

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