Kittikraisak Wanitchaya, Mohanty Sarita, Klungthong Chonticha, Macareo Louis, Rawangban Boonsong, Tomyabatra Krissada, Srisantiroj Nattinee, Phadungkiatwatana Podjanee, Chotpitayasunondh Tawee, Kanjanapattanakul Wiboon, Mott Joshua A, Kim Lindsay, Dawood Fatimah S
Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand.
Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Infect Dis. 2025 Apr 3. doi: 10.1093/infdis/jiaf165.
We estimated RSV and hMPV illness incidences among pregnant women and examined the association between antenatal RSV illness and preterm birth and small for gestational age (SGA).
Pregnant women aged ≥18 years were followed twice weekly until the end of pregnancy to identify illness episodes with >1 of myalgia, cough, runny nose/nasal congestion, sore throat, or difficulty breathing. Mid-turbinate nasal swabs were collected and tested for RSV and hMPV by real-time reverse-transcription PCR. Incidences were calculated. Cox proportional hazards regression was used to estimate hazard ratios (HRs) comparing participants with and without RSV illnesses for preterm birth (live birth before 37 weeks gestation) and SGA infant.
Among 2,764 participants, the median age was 29 years (interquartile range [IQR] 24-34) and the median enrollment gestational age was 10 weeks (IQR 7-14). Overall, 71 (3%) and 29 (1%) cases of RSV and hMPV illnesses were identified, respectively. Among these, 30 (42%) and 10 (34%), respectively, sought medical care. Incidence rates per 10,000 pregnant woman-months were 57 (95% confidence interval [CI] 44-72) for RSV and 23 (95% CI 16-33) for hMPV illnesses. Antenatal RSV illness in the third trimester conferred an increased risk of preterm birth (adjusted HR [aHR] 2.50, 95% CI 1.04-6.00) but not having an SGA infant (aHR 0.79, 95% CI 0.29 to 2.16).
Antenatal RSV illness was associated with some adverse antenatal outcomes. Pregnant women had a 0.4-0.7% risk of RSV illness per pregnancy month, of which one third resulted in medical visits.
我们估计了孕妇中呼吸道合胞病毒（RSV）和人偏肺病毒（hMPV）疾病的发病率，并研究了产前RSV疾病与早产及小于胎龄儿（SGA）之间的关联。
对年龄≥18岁的孕妇每周随访两次，直至妊娠结束，以确定出现以下一种以上症状的疾病发作：肌痛、咳嗽、流涕/鼻塞、咽痛或呼吸困难。采集中鼻甲鼻拭子，通过实时逆转录聚合酶链反应检测RSV和hMPV。计算发病率。采用Cox比例风险回归估计早产（妊娠37周前活产）和SGA婴儿的风险比（HR），比较有和没有RSV疾病的参与者。
在2764名参与者中，中位年龄为29岁（四分位间距[IQR]24 - 34），中位入组孕周为10周（IQR 7 - 14）。总体而言，分别确诊了71例（3%）RSV疾病和29例（1%）hMPV疾病。其中，分别有30例（42%）和10例（34%）寻求医疗护理。每10000名孕妇 - 月的发病率，RSV疾病为57（95%置信区间[CI]44 - 72），hMPV疾病为23（95%CI 16 - 33）。孕晚期的产前RSV疾病会增加早产风险（调整后HR[aHR]2.50，95%CI 1.04 - 6.00），但不会增加生出SGA婴儿的风险（aHR 0.79，95%CI 0.29至2.16）。
产前RSV疾病与一些不良产前结局相关。孕妇每月患RSV疾病的风险为0.4 - 0.7%，其中三分之一会就医。
