Risk of adverse pregnancy outcomes and seroprevalence for brucellosis in pregnant women exposed to goats or raw goat products in southern Thailand: a prospective cohort study.

BACKGROUND

Pregnant women infected with brucellosis have been shown to have higher odds of having been exposed to goats and raw goat products and adverse pregnancy outcomes. However, information on these associations in asymptomatic pregnant women is limited, particularly in the brucellosis-endemic areas. This study aimed to assess the association of a history of exposure to goats and/or raw goat products and the serological status of anti-Brucella abortus immunoglobulin G (IgG) with adverse pregnancy outcomes among pregnant women, and explore factors associated with having exposure to goats and/or raw goat products.

METHODS

A prospective cohort study was conducted among pregnant women from July 2015 to July 2016 at Songkhla province in southern Thailand. All pregnant women who came for antenatal care (ANC) visits were approached. Blood samples from the women who agreed to participate were randomly tested for anti-Brucella abortus IgG. The women were then followed for adverse pregnancy outcomes.

RESULTS

Of 666 pregnant women, the majority (74.4%) were aged 20-34 years and Muslim (89.2%), 30.6% indicated exposure to goats or raw goat products, and 17.3% had adverse pregnancy outcomes. Women rearing goats at home or having neighbors rearing goats were more likely to be exposed to goats or raw goat products by cutaneous contact. Of 465 women having a blood test, 3.7% had seropositive results for anti-Brucella abortus IgG. No association with adverse pregnancy outcomes was found in the women reporting any exposure to goat and raw goat products. Having the first ANC visit at the first trimester and history of preterm birth or low birth weight newborn were independent risk factors of adverse pregnancy outcomes. Women who had positive serological results were more likely to have a history of drinking raw goat milk than those who had negative results significantly.

CONCLUSIONS

Although no association between past exposure with goats and raw goat products and adverse pregnancy outcomes was found, women with past exposure showed positive anti-Brucella abortus IgG. Counseling on avoiding consumption of raw goat milk would be beneficial to prevent goat-related infection in pregnant women in this area.