Chikungunya infection in pregnancy – reassuring maternal and perinatal outcomes: a retrospective observational study

Abstract

Objective To evaluate pregnancy and neonatal outcomes, disease severity, and mother‐to‐child transmission of pregnant women with Chikungunya infection (CHIKV). Design Retrospective observational study. Setting Grenada. Population Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. Methods This descriptive study investigated 731 mother‐infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. Main outcome measures Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. Results Of 416 mother‐infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother‐to‐child transmission occurred in two (1.3%) mother‐infant pairs and two of eight intrapartum infections (25%). Conclusion CHIKV infection during pregnancy may be protective against long‐term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother‐to‐child transmission of CHIKV. Tweetable abstract Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.

The Innate Immune Response in DENV- and CHIKV-Infected Placentas and the Consequences for the Fetuses: A Minireview

“…Similar results were found by Foeller in Grenada (August-December 2014); however, they found intense arthralgia and myalgia but with shorter durations in women who became infected with CHIKV during gestation [131]. Both authors found that the frequency of newborns who need intensive care unit admission seems to be higher when the women are exposed to CHIKV within 1 week before delivery, as well as pregnancy complications [130,131]. In contrast, a study conducted in India between August and October 2016 enrolled 150 CHIKV-infected pregnant women with a mean period of gestation of 25.62 ± 13.475 weeks.…”

A Retrospective Study of the Seroprevalence of Dengue Virus and Chikungunya Virus Exposures in Nigeria, 2010–2018

“…Similarly, the detection of IgG antibodies in newborn could be suggestive of transplacental antibody transfer from mothers during pregnancy, as found in some studies [ 41 , 42 ]. This finding further suggests exposure in women of childbearing age, which could have harmful effects on their babies [ 43 ].…”

Susceptibility to endemic Aedes‐borne viruses among pregnant women in Risaralda, Colombia

“…Maternal and perinatal CHIKV infection has been associated with various clinical outcomes ( Ferreira et al , 2021 ). Some studies suggest minimal risk due to perinatal CHIKV infection, but small numbers of cases with severe outcomes including death advocate for systematic research on pregnancy outcomes in the context of CHIKV infection ( Ferreira et al , 2021 ;Escobar et al, 2017 ;Fritel et al, 2010 ;Foeller et al, 2021 ;. For three major ABV, the problems are exacerbated by challenges in access and equity in maternal-child health services ( Rodriguez-Morales et al, 2018 ;Tepper et al, 2016 ) and a lack of countermeasures such as antivirals and vaccines approved for use in pregnancy.…”