Departament of Neonatology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Independent Consultant, Maryland, United States of America.
PLoS One. 2021 Apr 23;16(4):e0249166. doi: 10.1371/journal.pone.0249166. eCollection 2021.
To describe and estimate the frequency of pregnancy outcomes, clinical and laboratory characteristics of vertical transmission of CHIKV in the neonate.
We performed a systematic review evaluating the clinical presentation of perinatally-acquired CHIKV infection in neonates. The search was performed using Medline (via PubMed), LILACS, Web of Science, Scielo, Google Scholar and Open grey to identify studies assessing vertical transmission of CHIKV up to November 3, 2020. There were no search restrictions regarding the study type, the publication date or language. Studies with no documented evidence of CHIKV infection in neonates (negative RT-PCR or absence of IgM) were excluded.
From the 227 studies initially identified, 42 were selected as follows: 28 case reports, 7 case series, 2 cross-sectional studies and 5 cohort studies, for a total of 266 CHIKV infected neonates confirmed by serological and/or molecular tests. The vertical transmission rate was 50% in the Reunion Island outbreak, which was the subject of the majority of the studies; the premature delivery were reported in 19 (45.2%) studies; the rate of fetal distress was 19.6% of infected babies and fetal loss occurred in 2% of the cases. Approximately 68.7% of newborns were diagnosed with encephalopathy or encephalitis after perinatally acquired CHIKV. Most of the infected neonates were born healthy, developing CHIKV sepsis clinical syndrome within the first week of life.
We alert neonatologists to the late manifestations of neonatal CHIKV infection, relevant to the management and reduction of morbidity. A limitation of our review was that it was not possible to carry out meta-analysis due to differences in study design and the small number of participants.
描述并估计垂直传播 CHIKV 感染的新生儿结局、临床和实验室特征。
我们进行了系统评价，评估了围生期获得性 CHIKV 感染新生儿的临床表现。通过 Medline（通过 PubMed）、LILACS、Web of Science、Scielo、Google Scholar 和 Open grey 进行搜索，以确定截至 2020 年 11 月 3 日评估 CHIKV 垂直传播的研究。研究类型、发表日期或语言没有搜索限制。排除了没有新生儿 CHIKV 感染（阴性 RT-PCR 或缺乏 IgM）的研究。
从最初确定的 227 项研究中，选择了 42 项，包括 28 项病例报告、7 项病例系列、2 项横断面研究和 5 项队列研究，共涉及 266 例经血清学和/或分子检测证实的 CHIKV 感染新生儿。留尼汪岛疫情中的垂直传播率为 50%，该疫情是大多数研究的主题；19 项研究报告早产；感染婴儿中胎儿窘迫的发生率为 19.6%，2%的病例发生胎儿丢失。大约 68.7%的新生儿在获得 CHIKV 后患有脑病或脑炎。大多数感染的新生儿出生时健康，在生命的第一周内发展为 CHIKV 败血症临床综合征。
我们提醒新生儿科医生注意新生儿 CHIKV 感染的晚期表现，这与管理和降低发病率有关。我们的综述存在一个局限性，即由于研究设计和参与者数量的差异，无法进行荟萃分析。
