Congenital Defects in a Year of Epidemic Rubella

Ober, R. E.; Horton, Ralph; Feemster, Roy F.

doi:10.2105/ajph.37.10.1328

Cited by 43 publications

(6 citation statements)

References 3 publications

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“…Table provides details about the 31 studies that met our selection criteria and provided data we could abstract related to pregnancy outcomes following maternal rubella infections . We excluded several additional studies due to their lack of data related to pregnancy outcomes .…”

Section: Resultsmentioning

confidence: 99%

“…We included only those studies that followed cohorts of at least 30 rubella infections in pregnancy, as shown in Fig. . We reviewed each article for eligibility, resolved disagreements by consensus, and looked for records missed by the database search by screening the references of relevant full‐text articles.…”

Section: Methodsmentioning

confidence: 99%

“…When appropriate, we converted gestational ages reported as the time since conception to the time since the LMP by subtracting two weeks . We assigned an appropriate limitation to any studies that did not report on timing of the rubella infection in pregnancy and in those cases we assumed the authors used timing relative to LMP consistent with recommended practice . Due to inconsistent definitions or the lack of adequate information provided by the authors and no ability to adjust for the potential differences in the natural history of rubella at the time of exposure, rash onset, and detectable viremia or antibody response, we used the timing of the onset of the maternal rubella infection explicitly or implicitly determined by the study authors (e.g., rash presentation, detection of an increase in antibody titer for laboratory‐detected asymptomatic infections, or timing of exposure).…”

Section: Methodsmentioning

confidence: 99%

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Characterization of the Risks of Adverse Outcomes Following Rubella Infection in Pregnancy

et al. 2014

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Although most infections with the rubella virus result in relatively minor sequelae, rubella infection in early pregnancy may lead to severe adverse outcomes for the fetus. First recognized in 1941, congenital rubella syndrome (CRS) can manifest with a diverse range of symptoms, including congenital cataracts, glaucoma, and cardiac defects, as well as hearing and intellectual disability. The gestational age of the fetus at the time of the maternal rubella infection impacts the probability and severity of outcomes, with infection in early pregnancy increasing the risks of spontaneous termination (miscarriage), fetal death (stillbirth), birth defects, and reduced survival for live-born infants. Rubella vaccination continues to change the epidemiology of rubella and CRS globally, but no models currently exist to evaluate the economic benefits of rubella management. This systematic review provides an overall assessment of the weight of the evidence for the outcomes associated with rubella infections in the first 20 weeks of pregnancy. We identified, evaluated, and graded 31 studies (all from developed countries) that reported on the pregnancy outcomes of at least 30 maternal rubella infections. We used the available evidence to estimate the increased risks of spontaneous termination, fetal death, infant death, and CRS as a function of the timing of rubella infection in pregnancy and decisions about induced termination. These data support the characterization of the disability-adjusted life years for outcomes associated with rubella infection in pregnancy. We find significant impacts associated with maternal rubella infections in early pregnancy, which economic analyses will miss if they only focus on live births of CRS cases. Our estimates of fetal loss from increased induced terminations due to maternal rubella infections provide context that may help to explain the relatively low numbers of observed CRS cases per year despite potentially large burdens of disease. Our comprehensive review of the weight of the evidence of all pregnancy outcomes demonstrates the importance of including all outcomes in models that characterize rubella-related disease burdens and costs.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Characterization of the Risks of Adverse Outcomes Following Rubella Infection in Pregnancy

et al. 2014

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“…It is interesting that the percentage of children affected is 28.7 in the Brisbane area and 28.2 for the country districts. In a a similar study, in which questionnaires were sent to 61000 physicians in Massachusetts, 49 women were reported as having rubella during preg nancy (50). Six infants from these gestations presented serious congenital malformations, representing 12.3 per cent.…”

Section: The Newborn Infantmentioning

confidence: 98%

Obstetrics

Hellman¹

1950

Annu. Rev. Med.

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The pre. sent review deals with a few of the significant advances in obstetrical practice and theory occurring in the year ending September 1, 1949. PREGNANCYPregnancy tests.-Based on the knowledge that the anterior pituitary hormone and chorionic gonadatropin in pregnant women's urine (1, 2) both have a spermatozoa liberating effect in the male toad, a number of pregnancy tests have been advocated using both male toads (3) and male frogs (4). Employing the male Batrachia,l Galli·Mainini (5) reports the ac· curacy of the results of this pregnancy test in 1,422 verifiable cases. In 916 instances the patient was not pregnant and negative results were obtained in all cases. In 462 cases of verified pregnancy, 458 positive results were obtained. In 623 specimens from nonpregnant subjects, men, women, and children, negative results were obtained in all instances. The rate of accuracy was thus 99.72 per cent. Forty·eight per cent of all the reactiont were positive in 1 hr. ,an additional 40 per cent within 2 hr. and the final 11 per cent within 24 hr.Using Rana pipiens, which is the common North American male frog, it has been reported by Wiltberger & Miller (4) that tests on 200 animals yielded no false negatives or false positives, provided the urine was obtained during the first trimester of pregnancy. These authors injected 5 cc. of the first morning urine in the dorsal or lateral lymph sac of the frog. Two or more frogs were used in each case, each frog was placed in a separate clean, dry, glass jar with a perforated lid and remained for 2 to 4 hr. at room temper ature. At the end of this time any urine that had been voided was examined microscopically. If spermatozoa were not present the urine was drained from the jar. The frog was then squeezed by hand while still in the jar. This pres sure usually induced another urination which was now examined. Robbins & Parker (6) performed a test in the same manner, except that they took cloacal smears from their animals beginnning 1 hr. after injection. They report the results on 122 urines, 10 of which were obtained from normal nonpregnant girls. In the remaining 112 urines there were 78 from known pregnancies, and 34 from patients with amenorrhea, who were determined t.o be nonpregnant by the Aschheim-Zondek or F � iedman tests. No false positive reactions were encountered, but there was one false negative on the urine of a patient who was only 2 weeks beyond her first missed period.In our own clinic (21) Rana pipiens has been used for preg-nancy tests in 1 Synonym for amphibia-more specific toads, tree toads, and frogs.

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“….31,6 % (from Ober, Horton and Feemster 1947) De schrijvers achten hun getallen zelf nog te klein om er conclusies uit te kunnen trekken i). Ook zij rangschikken de gegevens van de beide voorgaande en hun eigen onderzoekingen in.…”

Section: Wijze Van Onderzoekunclassified

Het rubella-probleem in het licht van Nederlandse ervaringen.

1951

Arch Pediatr Adolesc Med

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Na de aandacht gevestigd te hebben op de ontdekking van Gregg betreffende het verband tussen aangeboren afwijkingen en rubella-infectie tijdens de eerste maanden der zwangerschap, riep Prof. Dr P. H. G. van Gilse de medewerking van het Instituut voor Praeventieve Geneeskunde in, ten einde dit belangrijke vraagstuk in ons land te bestuderen en zo mogelijk preventieve maatregelen te treffen.Ik heb 'gaarne aan dit verzoek voldaan en in gezamenlijk overleg is door het Instituut een werkgroep ingesteld, waarin clinici, sociaal-geneeskundigen en laboratoriumartsen zitting hadden en waarvan Prof. van Gilse het voorzitterschap en Mejuffrouw A. E. H. M. Kamerbeek het secretariaat waarnamen.Bij het verschijnen van deze Verhandeling van het Instituut is een woord van dank aan de leden der werkgroep en zeer in het bijzonder aan haar secretaresse op zijn plaats. Zij toch heeft vrijwel alle werkzaamheden venrioht en de verhandeling samengesteld. Het verheugt mij dan ook zeer dat Mejxiffrouw Kamerbeek op dit onderzoek aan de Leidse Universiteit de graad van doctor in de geneeskunde hoopt te behalen.

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Congenital Defects in a Year of Epidemic Rubella

Cited by 43 publications

References 3 publications

Characterization of the Risks of Adverse Outcomes Following Rubella Infection in Pregnancy

Characterization of the Risks of Adverse Outcomes Following Rubella Infection in Pregnancy

Obstetrics

Het rubella-probleem in het licht van Nederlandse ervaringen.

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