Department of Obstetrics, Gynecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
World Association of Trainees in Obstetrics and Gynecology (WATOG), Paris, France.
Int J Gynaecol Obstet. 2023 Nov;163(2):466-475. doi: 10.1002/ijgo.14810. Epub 2023 May 2.
Data on mpox in pregnancy are currently limited. Historically, only 65 cases in pregnancy have been reported globally since mpox was discovered in 1958. This includes 59 cases in the current outbreak. Vertical transmission was confirmed in one patient. Pregnant women are at high risk of severe disease owing to immunological and hormonal changes that increase susceptibility to infections in pregnancy. African women appear to be at higher risk of mpox infection and adverse outcomes in pregnancy for epidemiological and immunologic reasons, in addition to the background high rates of adverse feto-maternal outcomes in the region. This risk is potentially heightened during the COVID-19 pandemic due to the possibility of mpox virus exportation/importation as a result of the lifting of movement restrictions and trans-border travels between countries affected by the current outbreak. Furthermore, coinfection with mpox and COVID-19 in pregnancy is possible, and the clinical features of both conditions may overlap. Challenges of diagnosis and management of mpox in pregnancy in Africa include patients concealing their travel history from healthcare providers and absconding from/evading isolation after diagnosis, shortage of personal protective equipment and polymerase chain reaction testing facilities for diagnosis, vaccine hesitancy/resistance, and poor disease notification systems. There is a need for local, regional and global support to strengthen the capacity of African countries to address these challenges and potentially reduce the disease burden among pregnant women in the continent.
关于妊娠猴痘的数据目前有限。自 1958 年发现猴痘以来，全球仅报告了 65 例妊娠猴痘病例，这包括目前疫情中的 59 例。其中一名患者被确认存在垂直传播。由于妊娠期间免疫和激素变化会增加感染易感性，孕妇罹患重病的风险很高。非洲妇女由于流行病学和免疫学原因，感染猴痘和妊娠不良结局的风险似乎更高，此外该地区不良母婴结局的发生率本来就很高。由于当前疫情中受影响国家之间的旅行限制放宽和跨境旅行，猴痘病毒可能会出口/输入，因此在 COVID-19 大流行期间，这种风险可能会增加。此外，妊娠期间同时感染猴痘和 COVID-19 是有可能的，并且这两种疾病的临床特征可能会重叠。非洲妊娠猴痘诊断和管理方面的挑战包括患者向医护人员隐瞒旅行史，以及在诊断后逃离/逃避隔离、个人防护设备和聚合酶链反应检测设施短缺、疫苗犹豫/抵制以及疾病通报系统不佳。需要在地方、区域和全球层面提供支持，以加强非洲国家的能力，应对这些挑战，并有可能减轻该大陆孕妇的疾病负担。
