Journal article
Plague During Pregnancy: A Systematic Review
Clinical infectious diseases, Vol.70(1), pp.S30-S36
05/21/2020
DOI: 10.1093/cid/ciz1228
PMID: 32435806
Abstract
Background. Yersinia pestis continues to cause sporadic cases and outbreaks of plague worldwide and is considered a tier 1 bioterrorism select agent due to its potential for intentional use. Knowledge about the clinical manifestations of plague during pregnancy, specifically the maternal, fetal, and neonatal risks, is very limited.
Methods. We searched 12 literature databases, performed hand searches, and consulted plague experts to identify publications on plague during pregnancy. Articles were included if they reported a case of plague during pregnancy and at least 1 maternal or fetal outcome.
Results. Our search identified 6425 articles, of which 59 were eligible for inclusion and described 160 cases of plague among pregnant women. Most published cases occurred during the preantibiotic era. Among those treated with antimicrobials, the most commonly used were sulfonamides (75%) and streptomycin (54%). Among cases treated with antimicrobials, maternal mortality and fetal fatality were 29% and 62%, respectively; for untreated cases, maternal mortality and fetal fatality were 67% and 74%, respectively. Five cases demonstrated evidence of Y. pestis in fetal or neonatal tissues.
Conclusions. Untreated Y. pestis infection during pregnancy is associated with a high risk of maternal mortality and pregnancy loss. Appropriate antimicrobial treatment can improve maternal survival, although even with antimicrobial treatment, there remains a high risk of pregnancy loss. Limited evidence suggests that maternal-fetal transmission of Y. pestis is possible, particularly in the absence of antimicrobial treatment. These results emphasize the need to treat or prophylax pregnant women with suspected plague with highly effective antimicrobials as quickly as possible.
Details
- Title: Subtitle
- Plague During Pregnancy: A Systematic Review
- Creators
- Shannon Fleck-Derderian - Centers for Disease Control and PreventionChristina A. Nelson - Centers for Disease Control and PreventionKatharine M. Cooley - Synergy AmericaZachary Russell - National Center on Birth Defects and Developmental DisabilitiesShana Godfred-Cato - Centers for Disease Control and PreventionNadia L. Oussayef - National Center for Emerging and Zoonotic Infectious DiseasesTitilope Oduyebo - National Center for Chronic Disease Prevention and Health PromotionSonja A. Rasmussen - Florida CollegeDenise J. Jamieson - Emory UniversityDana Meaney-Delman - Centers for Disease Control and Prevention
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.70(1), pp.S30-S36
- Publisher
- Oxford Univ Press
- DOI
- 10.1093/cid/ciz1228
- PMID
- 32435806
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Number of pages
- 7
- Grant note
- Office of the Assistant Secretary for Preparedness and Response CDC; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA
- Language
- English
- Date published
- 05/21/2020
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446542402771
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