坦桑尼亚姆万扎市急性风疹感染孕妇的不良妊娠结局。

Adverse pregnancy outcomes among pregnant women with acute Rubella infections in Mwanza city, Tanzania.

机构信息

Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania.

Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.

出版信息

Int J Infect Dis. 2019 Jan;78:72-77. doi: 10.1016/j.ijid.2018.10.020. Epub 2018 Nov 1.

DOI:10.1016/j.ijid.2018.10.020

PMID:30391418

Abstract

OBJECTIVE

This study investigated the adverse pregnancy outcomes among pregnant women with acute Rubella infections in the city of Mwanza, Tanzania.

METHODS

A longitudinal study was conducted between 2014 and 2016 among pregnant women attending antenatal clinics. Women were screened for Rubella IgG and IgM antibodies using enzyme immunoassay (EIA). IgM seropositive pregnant women were followed up until the end of the pregnancy to determine Congenital Rubella Syndrome, congenital infections and other pregnancy outcomes.

RESULTS

The median age of 685 enrolled pregnant women was 23 (IQR: 19-27) years. A total of 629(91.8%) were Rubella IgG seropositive while 61 (8.9%) were IgM seropositive. The IgM seropositivity was found to decrease significantly from first trimester to third trimester, p<0.001. Forty six (83.6%) of 55 Rubella IgM seropositive women had adverse pregnancy outcomes and 6 (10.9%) delivered neonates with CRS, making the overall incidence of CRS to be 6/685 (0.87%). First trimester IgM seropositive women had significantly higher adverse pregnancy outcomes than those in second/third trimesters (70.4% vs. 35.7, p=0.01).

CONCLUSION

There is one case of CRS in every 100 pregnancies necessitating additional strategies to reach a goal of elimination of CRS in developing countries.

摘要

目的

本研究旨在调查坦桑尼亚姆万扎市急性风疹感染孕妇的不良妊娠结局。

方法

2014 年至 2016 年期间，我们对在产前诊所就诊的孕妇进行了一项纵向研究。采用酶联免疫吸附试验（EIA）检测风疹 IgG 和 IgM 抗体。对 IgM 血清阳性的孕妇进行随访，直至妊娠结束，以确定先天性风疹综合征、先天性感染和其他妊娠结局。

结果

纳入的 685 名孕妇的中位年龄为 23 岁（IQR：19-27 岁）。共有 629 名（91.8%）孕妇风疹 IgG 血清阳性，61 名（8.9%）孕妇 IgM 血清阳性。IgM 血清阳性率从第一孕期到第三孕期显著下降，p<0.001。55 名风疹 IgM 血清阳性孕妇中有 46 名（83.6%）出现不良妊娠结局，6 名（10.9%）分娩的新生儿患有 CRS，CRS 的总发生率为 6/685（0.87%）。第一孕期 IgM 血清阳性孕妇的不良妊娠结局发生率显著高于第二/第三孕期（70.4%比 35.7%，p=0.01）。