Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight in Nepal.
Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight in Nepal.
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DOI：
10.1093/ofid/ofx073
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发表时间：
2017
影响因子：
4.2
通讯作者：
Chu HY
中科院分区：
文献类型：
--
作者：
Philpott EK;Englund JA;Katz J;Tielsch J;Khatry S;LeClerq SC;Shrestha L;Kuypers J;Magaret AS;Steinhoff MC;Chu HY
不良出生结局，包括低出生体重(LBW)(定义为2500克)、小于胎龄儿(SGA)和早产，占全球婴儿死亡率的60%-80%，可能与孕期感染有关。这项研究的目的是评估发热性人类鼻病毒(HRV)疾病是否与不利的出生结局相关。作为尼泊尔农村孕产妇流感免疫接种社区前瞻性随机试验的一部分，对孕妇的呼吸道疾病发作进行了每周以家庭为基础的积极监测。鼻病毒(HRV)发热性疾病发作被定义为发热加咳嗽、喉咙痛、流鼻水和/或肌肉痛，并在中鼻拭子上检测到HRV。多变量回归分析评估了发热性HRV呼吸系统疾病与不良出生结局之间的关系。总体而言，3693名孕妇中有96人(3%)患有HRV阳性的发热性呼吸道疾病。患有HRV发热性疾病的孕妇所生婴儿患LBW的风险是非HRV发热性疾病孕妇所生婴儿的1.6倍(96例中有28例[38%]对458例中109例[24%]；相对危险度[RR]为1.6；95%可信区间[CI]为1.1-2.3)。孕期患有非HRV热性呼吸道疾病的母亲所生婴儿与孕期未患呼吸道疾病的母亲所生婴儿发生LBW的风险无差异(分别为458例中的109例[24%]和2220例中的552例[25%]；RR为1.0；95%CI为0.8-1.2)。在南亚农村人口中，怀孕期间因鼻病毒引起的发热性疾病与LBW风险增加有关。减少孕期鼻病毒引起的发热性呼吸道疾病负担的干预措施可能会对LBW和随后的婴儿死亡率产生重大影响。
Adverse birth outcomes, including low birth weight (LBW), defined as <2500 grams, small-for-gestational-age (SGA), and prematurity, contribute to 60%–80% of infant mortality worldwide and may be related to infections during pregnancy. The aim of this study was to assess whether febrile human rhinovirus (HRV) illness is associated with adverse birth outcomes. Active household-based weekly surveillance was performed for respiratory illness episodes in pregnant women as part of a community-based, prospective, randomized trial of maternal influenza immunization in rural Nepal. Rhinovirus (HRV) febrile illness episodes were defined as fever plus cough, sore throat, runny nose, and/or myalgia with HRV detected on mid-nasal swab. Multivariate regression analysis evaluated the association between febrile HRV respiratory illness and adverse birth outcomes. Overall, 96 (3%) of 3693 pregnant women had HRV-positive febrile respiratory illnesses. Infants born to pregnant women with HRV febrile illness had a 1.6-fold increased risk of being LBW compared with those with non-HRV febrile illness (28 of 96 [38%] vs 109 of 458 [24%]; relative risk [RR], 1.6; 95% confidence interval [CI], 1.1–2.3). No difference in risk of LBW was observed between infants born to mothers with non-HRV febrile respiratory illness and those without respiratory illness during pregnancy (109 of 458 [24%] vs 552 of 2220 [25%], respectively; RR, 1.0; 95% CI, 0.8–1.2). Febrile illness due to rhinovirus during pregnancy was associated with increased risk of LBW in a rural South Asian population. Interventions to reduce the burden of febrile respiratory illness due to rhinovirus during pregnancy may have a significant impact on LBW and subsequent infant mortality.