Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", 80131, Naples, Italy.
Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", 80131, Naples, Italy.
J Infect. 2020 Feb;80(2):152-160. doi: 10.1016/j.jinf.2019.12.012. Epub 2019 Dec 28.
Pregnant women represent a category at high risk of severe measles infection, that negatively affects the fetus as well. A systematic review of clinical outcomes of measles infection in gravid subjects and a meta-analysis of antibodies prevalence among pregnant women was conducted.
MEDLINE and EMBASE databases were searched up to 18 June 2018. The screening focused on: (i) articles describing the outcome of measles in pregnancy, synthesized in a descriptive fashion; (ii) articles addressing the measles seroprevalence in cohorts of gravid women, analysed quantitatively.
Twenty-nine articles met inclusion criteria. A total of 420 cases of measles in gravid subjects were described, from 1941 to 2012. Among women, 18 deaths (4.3%) occurred, and the most frequent complication was pneumonia (75/420, 17.9%). Prematurity was the most important complication concerning fetal outcomes (55 out of 410 cases with available data, 13.4%). The random-effects pooled seroprevalence of measles in 20,546 gravid women worldwide was 89.3% (95% CI: 87.3-91.1%), that decreased, although not in a statistically significant way, over time (p = 0.54).
Measles infection in pregnancy is dangerous both for the mother and the foetus. Antibody seroprevalence among gravid women on a global scale is lower than the herd immunity threshold.
孕妇属于麻疹感染的高危人群，这会对胎儿产生负面影响。本研究对孕妇麻疹感染的临床结局进行了系统评价和荟萃分析，并对孕妇抗体阳性率进行了评估。
检索 MEDLINE 和 EMBASE 数据库，检索时间截至 2018 年 6 月 18 日。筛选标准包括：（i）描述麻疹感染孕妇结局的文章，以描述性方式进行综合分析；（ii）针对孕妇队列中麻疹血清阳性率的文章，进行定量分析。
共有 29 篇文章符合纳入标准。1941 年至 2012 年间，共描述了 420 例孕妇麻疹感染病例。其中，18 例（4.3%）死亡，最常见的并发症是肺炎（75/420，17.9%）。早产是胎儿结局最重要的并发症（410 例中有 55 例，占 13.4%）。全球范围内 20546 名孕妇麻疹的随机效应荟萃分析血清阳性率为 89.3%（95%CI：87.3-91.1%），虽然没有统计学意义，但随着时间的推移呈下降趋势（p=0.54）。
孕妇麻疹感染对母亲和胎儿都有危险。全球孕妇抗体阳性率低于群体免疫阈值。
