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Clin Infect Dis. 2017 Jul 15;65(2):292-299. doi: 10.1093/cid/cix290.

Ebola Virus Disease and Pregnancy: A Retrospective Cohort Study of Patients Managed at 5 Ebola Treatment Units in West Africa.

Author information

1
Department of Emergency Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
2
International Medical Corps, Los Angeles, California.
3
Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, and Massachusetts General Hospital Center for Global Health, Boston.
4
Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island.

Abstract

Background:

Reliable data are lacking on pregnancy outcomes during Ebola virus disease (EVD) epidemics. We aimed to characterize symptoms and outcomes among pregnant women admitted to Ebola treatment units (ETUs) with suspected and confirmed EVD to better inform obstetric management.

Methods:

We analyzed a retrospective cohort of reproductive-aged women presenting to 5 West African ETUs from September 2014 to September 2015. We compared clinical symptoms, risk of EVD diagnosis, and mortality between pregnant and nonpregnant women.

Results:

Of 729 reproductive-aged women admitted to study ETUs, 44 (6%) reported pregnancy. Thirteen of 44 pregnant women (30%) tested EVD positive; 6 of 13 (46%) died. Pregnant women were less likely than nonpregnant women to report anorexia, asthenia, diarrhea, fever, myalgias/arthralgias, nausea, or vomiting (P < .05) at admission. Pregnant women with suspected EVD had the same risk, however, of laboratory-confirmed EVD (30% vs 24%, P = .38). While pregnant women with confirmed EVD had similar Ebola viral loads on presentation to nonpregnant women, as measured by initial cycle threshold (26.4 vs 23.2, P = .16), they were less likely to have myalgias/arthralgias (P< .001) and vomiting (P = .02). Both all-cause mortality (14% vs 19%, P = .39) and EVD-specific mortality (46% vs 54%, P = .60) were not significantly different between pregnant and nonpregnant women. Two neonates born live in the ETU died within 8 days.

Conclusions:

We find no evidence to support a difference in the risk of death between pregnant women with suspected or confirmed EVD compared to nonpregnant women. Limited data suggest poor fetal and neonatal outcomes in EVD-affected pregnancies.

KEYWORDS:

Ebola virus disease; Liberia; Sierra Leone; maternal mortality; pregnant

PMID:
28379374
PMCID:
PMC5850452
DOI:
10.1093/cid/cix290
[Indexed for MEDLINE]
Free PMC Article

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