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PLoS One. 2016 Mar 31;11(3):e0152015. doi: 10.1371/journal.pone.0152015. eCollection 2016.

Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy.

Author information

1
Department of Medicine, University of Washington, Seattle, WA, 98102, United States of America.
2
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
3
Department of Global Health, George Washington University, Washington, D.C., United States of America.
4
Nepal Nutrition Intervention Project-Sarlahi, Sarlahi, Nepal.
5
Department of Pediatrics and Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
6
Department of Laboratory Medicine, University of Washington, Seattle, WA, 98102, United States of America.
7
Department of Biostatistics, University of Washington, Seattle, WA, 98102, United States of America.
8
Global Health Center, Cincinnati Children's Hospital, Cincinnati, OH, 45229, United States of America.
9
Department of Infectious Diseases, Seattle Children's Hospital, University of Washington, Seattle, WA, 98105, United States of America.

Abstract

BACKGROUND:

Respiratory syncytial virus (RSV) is the most important cause of viral pneumonia in children worldwide. A maternal vaccine may protect both the mother and infant from RSV illness. The epidemiology and clinical presentation of RSV in pregnant and postpartum women is not well-described.

METHODS:

Data were collected from a prospective, randomized trial of influenza immunization in pregnant women in rural southern Nepal. Women were enrolled in their second trimester of pregnancy and followed until six months postpartum. Active weekly home-based surveillance for febrile respiratory illness was performed. Mid-nasal swabs collected with episodes of respiratory illness were tested for RSV by real-time polymerase chain reaction.

RESULTS:

RSV was detected in 14 (0.4%) illness episodes in 3693 women over 3554 person-years of surveillance from 2011-2014. RSV incidence was 3.9/1000 person-years overall, and 11.8/1000 person-years between September and December. Seven (50%) women sought care for RSV illness; none died. Of the 7 (50%) illness episodes during pregnancy, all had live births with 2 (29%) preterm births and a median birthweight of 3060 grams. This compares to 469 (13%) preterm births and a median birthweight of 2790 grams in women without RSV during pregnancy. Of the 7 mothers with postpartum RSV infection, RSV was detected in 4 (57%) of their infants.

CONCLUSIONS:

RSV was an uncommon cause of febrile respiratory illness in mothers during pregnancy in Nepal. These data will inform prevention and therapeutic strategies against RSV in resource-limited settings.

PMID:
27031702
PMCID:
PMC4816499
DOI:
10.1371/journal.pone.0152015
[Indexed for MEDLINE]
Free PMC Article

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