Division of Community Health and Family Medicine, Bangalore Baptist Hospital, Bangalore, Karnataka560024, India.
Department of Microbiology, Bangalore Baptist Hospital, Bangalore, Karnataka560024, India.
Epidemiol Infect. 2021 Feb 26;149:e63. doi: 10.1017/S0950268821000492.
Varicella infection during pregnancy has serious and/or difficult implications and in some cases lethal outcome. Though epidemiological studies in developing countries reveal that a significant proportion of patients may remain susceptible during pregnancy, such an estimate of susceptible women is not known in India. We designed this study to study the prevalence and factors associated with susceptibility to varicella among rural and urban pregnant women in South India. We prospectively recruited 430 pregnant women and analysed their serum varicella IgG antibodies as surrogates for protection. We estimated seroprevalence, the validity of self-reported history of chickenpox and factors associated with varicella susceptibility. We found 23 (95% CI 19.1-27.3) of women were susceptible. Nearly a quarter (22.2%) of the susceptible women had a history of exposure to chickenpox anytime in the past or during the current pregnancy. Self-reported history of varicella had a positive predictive value of 82.4%. Negative history of chickenpox (adjusted prevalence ratio (PR) 1.85, 95% CI 1.15-3.0) and receiving antenatal care from a rural secondary hospital (adjusted PR 4.08, 95% CI 2.1-7.65) were significantly associated with susceptibility. We conclude that high varicella susceptibility rates during pregnancy were noted and self-reported history of varicella may not be a reliable surrogate for protection.
妊娠期间感染水痘具有严重和/或困难的影响，在某些情况下会导致致命后果。尽管发展中国家的流行病学研究表明，相当一部分患者在怀孕期间可能仍然易感，但印度尚不清楚易感妇女的估计数。我们设计了这项研究，以研究印度南部农村和城市孕妇中水痘的流行率和与易感性相关的因素。我们前瞻性招募了 430 名孕妇，并分析了她们血清中水痘 IgG 抗体作为保护的替代物。我们估计了血清阳性率、自我报告的水痘病史的有效性以及与水痘易感性相关的因素。我们发现 23 名（95%CI 19.1-27.3）女性易受感染。近四分之一（22.2%）的易感妇女在过去或当前怀孕期间曾有过接触水痘的病史。自我报告的水痘病史的阳性预测值为 82.4%。没有患过水痘的病史（调整后的患病率比（PR）1.85，95%CI 1.15-3.0）和在农村二级医院接受产前护理（调整后的 PR 4.08，95%CI 2.1-7.65）与易感性显著相关。我们得出结论，妊娠期间水痘的高易感性率很高，自我报告的水痘病史可能不是保护的可靠替代物。
