Chu Helen Y, Katz Joanne, Tielsch James, Khatry Subarna K, Shrestha Laxman, LeClerq Steven C, Magaret Amalia, Kuypers Jane, Steinhoff Mark C, Englund Janet A
Department of Medicine, University of Washington, Seattle, WA, 98102, United States of America.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
PLoS One. 2016 Mar 31;11(3):e0152015. doi: 10.1371/journal.pone.0152015. eCollection 2016.
Respiratory syncytial virus (RSV) is the most important cause of viral pneumonia in children worldwide. A maternal vaccine may protect both the mother and infant from RSV illness. The epidemiology and clinical presentation of RSV in pregnant and postpartum women is not well-described.
Data were collected from a prospective, randomized trial of influenza immunization in pregnant women in rural southern Nepal. Women were enrolled in their second trimester of pregnancy and followed until six months postpartum. Active weekly home-based surveillance for febrile respiratory illness was performed. Mid-nasal swabs collected with episodes of respiratory illness were tested for RSV by real-time polymerase chain reaction.
RSV was detected in 14 (0.4%) illness episodes in 3693 women over 3554 person-years of surveillance from 2011-2014. RSV incidence was 3.9/1000 person-years overall, and 11.8/1000 person-years between September and December. Seven (50%) women sought care for RSV illness; none died. Of the 7 (50%) illness episodes during pregnancy, all had live births with 2 (29%) preterm births and a median birthweight of 3060 grams. This compares to 469 (13%) preterm births and a median birthweight of 2790 grams in women without RSV during pregnancy. Of the 7 mothers with postpartum RSV infection, RSV was detected in 4 (57%) of their infants.
RSV was an uncommon cause of febrile respiratory illness in mothers during pregnancy in Nepal. These data will inform prevention and therapeutic strategies against RSV in resource-limited settings.
呼吸道合胞病毒（RSV）是全球儿童病毒性肺炎的最重要病因。母体疫苗可能保护母亲和婴儿免受RSV疾病侵害。RSV在孕妇和产后妇女中的流行病学和临床表现尚未得到充分描述。
数据收集自尼泊尔南部农村地区孕妇流感免疫的一项前瞻性随机试验。妇女在妊娠中期入组，并随访至产后六个月。每周进行一次基于家庭的发热呼吸道疾病主动监测。对呼吸道疾病发作时采集的中鼻拭子进行实时聚合酶链反应检测RSV。
在2011年至2014年3554人年的监测中，3693名妇女中有14例（0.4%）疾病发作检测到RSV。RSV总体发病率为3.9/1000人年，9月至12月期间为11.8/1000人年。7名（50%）妇女因RSV疾病寻求治疗；无人死亡。在孕期的7例（50%）疾病发作中，所有孕妇均分娩活婴，其中2例（29%）早产，中位出生体重为3060克。相比之下，孕期未感染RSV的妇女中有469例（13%）早产，中位出生体重为2790克。在7例产后感染RSV的母亲中，其婴儿有4例（57%）检测到RSV。
在尼泊尔，RSV是孕期母亲发热呼吸道疾病的罕见病因。这些数据将为资源有限环境中针对RSV的预防和治疗策略提供依据。
