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Xiong YQ, Tan J, Liu YM, He Q, Li L, Zou K, Sun X. The risk of maternal parvovirus B19 infection during pregnancy on fetal loss and fetal hydrops: A systematic review and meta-analysis. J Clin Virol 2019; 114:12-20. [PMID: 30897374 DOI: 10.1016/j.jcv.2019.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/11/2019] [Accepted: 03/07/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Human parvovirus B19 (B19) is widespread infection in humans, yet the impact on adverse pregnancy outcomes is controversial. OBJECTIVE to evaluate the impact of B19 infection during pregnancy on adverse pregnancy outcome, and investigated the incidence of fetal loss and fetal hydrops after maternal B19 infection during pregnancy. STUDY DESIGN A systematic literature search was performed using Embase, Medline, PubMed, Web of science, and the Cochrane Library database for relevant publications up to 10th August 2018. Cohort studies and case-control studies were included in analyses. RESULTS In total, 36 eligible studies were included. Of these, 18 studies reported the risk of maternal B19 infection during pregnancy on fetal loss and 20 studies reported the incidence of fetal loss or fetal hydrops after maternal B19 infection. Collectively, the results indicated that maternal B19 infection increased the risk of fetal loss, spontaneous abortion, and stillbirth with ORs of 2.68 (95% CI: 2.02-3.55), 2.42 (95% CI: 1.76-3.33), and 3.53 (95% CI: 1.91-6.54), respectively, when compared with uninfected pregnant women. In addition, the incidence of fetal loss and fetal hydrops in B19 infected pregnant women was 7.6% (95% CI: 5.5-9.5) and 9.3% (95% CI: 5.6-13.0), respectively. CONCLUSIONS maternal parvovirus B19 infection during pregnancy increased the risk of fetal loss, spontaneous abortion, and stillbirth. A high incidence of fetal loss and fetal hydrops was observed in pregnant women with parvovirus B19 infection.
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Affiliation(s)
- Yi-Quan Xiong
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jing Tan
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yan-Mei Liu
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qiao He
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ling Li
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Kang Zou
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xin Sun
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Karami A, Hoseini SL, Ramazani A, Emadi P, Gholami H, Hoseini SM. Prevalence of Parvovirus B19 Infection by Serology and PCR in Pregnant Women Referring to Obstetrics and Gynecology Clinic. J Natl Med Assoc 2019; 112:91-96. [PMID: 30712919 DOI: 10.1016/j.jnma.2018.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Infection by Primate erythroparvovirus 1, generally known Parvovirus B19, is highly prevalent worldwide. Although infection by this virus will not be clinically problematic in most cases, new infections during pregnancy could result in serious repercussions in the fetus. Serologic and PCR-based methods are among the available approaches for diagnosis of Parvovirus B19 infection. In this regard, the present study is aimed to investigate the frequency of Parvovirus B19 infection by these two techniques in pregnant women of Zanjan. MATERIALS AND METHODS In this cross sectional-descriptive study, 110 pregnant women referring to Mousavi hospital in Zanjan during one year were evaluated in terms of serologic and Real-Time PCR test results in search for Parvovirus B19 infection. The rate of positive IgG and IgM were determined in women and the Real-Time PCR results were reported. RESULTS Overall, 18.2% of participants were above 35 years old and 4.5% of them were younger than 18 years old. 41 (44.1%) and 2 (1.8%) cases had positive anti-Parvovirus B19 IgG and IgM, respectively. Real-Time PCR results were negative in all the studied samples. CONCLUSION Based on the findings of this study, prevalence of acute Parvovirus B19 infection was 0 and 2% based on Real-Time PCR and IgM tests, respectively. About 40% of pregnant women had experienced infection with this virus before.
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Affiliation(s)
- Afsaneh Karami
- Department of Infectious Disease, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Ali Ramazani
- Department of Biotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Parisa Emadi
- Department of Biotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hamideh Gholami
- Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Seyed Mahdi Hoseini
- Department of Infectious Disease, Zanjan University of Medical Sciences, Zanjan, Iran
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İnci A, Esmer AÇ. Investigation of Parvovirus B19 IgG and IgM antibodies with ELISA, distribution with regard to age groups and comparison with literature. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2018. [DOI: 10.5799/jcei.413067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
SUMMARYParvovirus B19 (B19V) infection during pregnancy may have serious consequences like fetal anaemia, hydrops fetalis, and fetal loss. Since epidemiological data on B19V infection are generally lacking in Sudan, the current study aimed to determine the seroprevalence of B19V in Sudanese pregnant women. Five hundred women, attending antenatal clinics in Khartoum state between November 2008 and March 2009, were enrolled and screened for B19V IgG and IgM antibodies by enzyme immunoassays. The study revealed a B19V IgG seroprevalence of 61·4%, with one subject positive for IgM. B19V DNA was not detected by PCR in any of the tested individuals. B19V IgG seroprevalence was significantly correlated with multigravidity (P = 0·046). Our data showed that B19V infection is prevalent in Sudan and we recommend further studies in Sudanese women, particularly in those with complications and adverse outcomes of pregnancy.
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Nigro G, Mazzocco M, Mattia E, Di Renzo GC, Carta G, Anceschi MM. Role of the infections in recurrent spontaneous abortion. J Matern Fetal Neonatal Med 2011; 24:983-9. [PMID: 21261443 DOI: 10.3109/14767058.2010.547963] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Embryo-fetal infections have been reported to cause recurrent spontaneous abortions (RSAs) at a rate lower than 4%. The possible mechanisms include production of toxic metabolic byproducts, fetal or placental infection, chronic endometrial infection, and chorio-amnionitis. Viruses appear to be the most frequently involved pathogens, since some of them can produce chronic or recurrent maternal infection. In particular, cytomegalovirus during pregnancy can reach the placenta by viremia, following both primary and recurrent infection, or by ascending route from the cervix, mostly following reactivation. Another herpesvirus, herpes simplex virus type 2, less frequently type 1, causes recurrent infections of the genital tract, which can involve the feto-placental unit. Parvoviruses have also been implicated in the development of repeated fetal loss. Among bacterial infections, Chlamydia trachomatis, Ureaplasma urealyticum,and Mycoplasma hominis have been mostly associated with occurrence of RSA. An increased risk of abortion among women with bacterial vaginosis (BV) during early pregnancy was also shown, but questions arise about the role of chronic BV in its occurrence. Although a definitive relationship between recurrently active infections and RSA is still lacking, mostly due to difficulties in demonstrating the pathogenic role of each individual isolated pathogen, diagnosis and therapy of RSA-related infections should be attempted. The diagnosis of infectious agents as a possible cause of RSA might lead to a therapeutic approach with antiviral drugs and antibiotics or using immunoglobulins, which can display both anti-infective neutralizing and immunomodulating properties.
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Affiliation(s)
- Giovanni Nigro
- Maternal-Infant Department, University of L'Aquila, San Salvatore Hospital, L'Aquila, Italy.
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Chan LW, Lau TK, Chung TKH. Fetal anaemia as a cause of fetal injury: diagnosis and management. Curr Opin Obstet Gynecol 2008; 18:100-5. [PMID: 16601468 DOI: 10.1097/01.gco.0000192981.69352.dc] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review provides up-to-date information on the diagnosis and management of fetal anaemia. RECENT FINDINGS Exciting advances in the field of red blood cell isoimmunization are phasing out the need for invasive procedures. Rhesus blood group genotyping using fetal DNA in maternal plasma has been introduced into clinical practice with remarkable success. The role of middle cerebral artery peak systolic velocity in screening for fetal anaemia has been confirmed in various causes of fetal anaemia. A recent review of a successful Iran national screening programme for thalassaemia provided a timely and valuable educational opportunity. The value of intrauterine transfusion as a treatment for fetal anaemia was demonstrated by both high success rate and low procedure-related pregnancy loss rate. SUMMARY Fetal anaemia is one of the severe fetal conditions that affect the worldwide population. Rhesus isoimmunization remains an important health issue despite the recommendation for anti-D immunoglobulin prophylaxis and injection after sensitizing events. Noninvasive ultrasound diagnostic methods have replaced traditional invasive procedures in the assessment of fetus at risk of anaemia due to various causes, including red blood cell isoimmunization, parvovirus B19 infection and thalassaemia. The increased availability of intrauterine transfusion will help to improve the prognosis of these anaemic fetuses.
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Affiliation(s)
- Lin Wai Chan
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
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Abstract
Acute parvovirus B19 infection is a risk for pregnant women. After vertical transmission the infected fetus may develop hydrops fetalis. Since B19 infection occurs mainly during childhood, children represent a main source for virus transmission. In order to determine whether certain groups in the German population show increased risks for B19 infection we analysed the seroprevalence using 6583 sera collected from adults in former Eastern and Western Germany during the German National Health Survey and 649 sera from healthy Thuringian children and adolescents. In adults the overall seroprevalence was 72.1%, rising from 20.4% in children (1-3 years) and 66.9% in adolescents (18-19 years) to 79.1% in the elderly (65-69 years). Significant differences were observed between females (73.3%) and males (70.9%) and between inhabitants of small (74.8%) and big cities (69.0%) but not between people of the former Eastern (72.8%) and Western states (72.0%) of Germany. For women during childbearing age (18-49 years) highest values were observed in those living together with two or more children (81.6%) and in women with occupational contact with children aged <6 years (88.9%). In contrast seroprevalence was significantly lower in age-matched female singles (64.8%) and in women with occupational contact with children aged >6 years and adolescents (63.8%).
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da Silva ARA, Nogueira SA, Alzeguir JCL, da Costa MCFL, do Nascimento JP. Prevalência de anticorpos IgG antiparvovírus B19 em gestantes durante o atendimento pré-natal e casos de hidropisia fetal não imune atribuídos ao parvovírus B19, na Cidade do Rio de Janeiro. Rev Soc Bras Med Trop 2006; 39:467-72. [PMID: 17160325 DOI: 10.1590/s0037-86822006000500009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2005] [Accepted: 08/26/2006] [Indexed: 11/21/2022] Open
Abstract
Com o objetivo de medir a prevalência de anticorpos IgG contra o parvovírus B19 em gestantes com até 24 semanas de idade gestacional e detectar a ocorrência de casos de hidropisia fetal não-imune atribuídos a esse vírus, coletamos 249 amostras de soro em uma maternidade de referência na cidade do Rio de Janeiro, entre junho de 2003 e março de 2005. As gestantes foram acompanhadas até o termo da gestação, sendo detectados 17 casos de hidropisia fetal. Quatro casos foram atribuídos ao parvovírus B19 e dois destes ocorreram em gestantes residentes na zona oeste da cidade, em fevereiro de 2005. Resultados positivos para anticorpos IgG antiparvovírus B19 foram encontrados em 172 (71,6%) gestantes (IC 95% 65,5-77,7%), sendo esta prevalência de anticorpos comparável à encontrada em outras cidades brasileiras. A única variável associada com aquisição prévia de anticorpos IgG foi número de gestações anteriores maior que um(p= 0,02, IC 95% 0,36-0,94).
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van Gessel PH, Gaytant MA, Vossen ACTM, Galama JMD, Ursem NTC, Steegers EAP, Wildschut HIJ. Incidence of parvovirus B19 infection among an unselected population of pregnant women in the Netherlands: A prospective study. Eur J Obstet Gynecol Reprod Biol 2006; 128:46-9. [PMID: 16406220 DOI: 10.1016/j.ejogrb.2005.11.042] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2005] [Revised: 11/15/2005] [Accepted: 11/29/2005] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate seroprevalence of anti-parvovirus B19 IgG immunoglobulins and the rate of seroconversion in seronegative pregnant women. DESIGN Prospective assessment of anti-parvovirus B19 IgG immunoglobulins in an unselected population of pregnant women booked for antenatal care from 1998 to 2000. SETTING Maternity departments of an academic hospital and four affiliated teaching hospitals in the Netherlands. SUBJECTS Two thousand five hundred and sixty seven pregnant women. MAIN OUTCOME MEASURES Seroprevalence of anti-parvovirus B19 IgG immunoglobulin in the first trimester of pregnancy and subsequent seroconversion in those women who were tested negative for parvovirus B19 antibodies in the first trimester of pregnancy. RESULTS The estimated seroprevalence of anti-parvovirus B19 IgG immunoglobulins among the study population is 70% (95% CI: 68-71) in the first trimester of pregnancy. Seven hundred and seventy nine women tested negative for parvovirus B19 antibodies in the first trimester of pregnancy. Paired testing in these women confirmed 18 seroconversions. Based on these findings the estimated incidence of maternal parvovirus B19 infection in this population among seronegative Dutch women is 2.4% (95% CI: 1.4-3.7). CONCLUSION Maternal infection with parvovirus B19 is relatively common. However, it is argued that in the Netherlands routine assessment of parvovirus antibodies in pregnant women is not warranted as there is a low risk of adverse fetal outcome and measures to prevent the parvovirus B19 infection and its consequences are very limited.
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Affiliation(s)
- Peter H van Gessel
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Odland JØ, Sergejeva IV, Ivaneev MD, Jensen IP, Stray-Pedersen B. Seropositivity of cytomegalovirus, parvovirus and rubella in pregnant women and recurrent aborters in Leningrad County, Russia. Acta Obstet Gynecol Scand 2001; 80:1025-9. [PMID: 11703200 DOI: 10.1034/j.1600-0412.2001.801110.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The objectives of this paper were to assess the prevalence of different viral infections in relation to late abortions, stillbirths, and congenital malformations in sera from Russian pregnant women and recurrent aborters in order to establish basic knowledge for future pregnancy care. METHODS Patients were recruited at the Women's Clinic, Leningrad Regional Hospital during the period March-June 1995. One group of normally pregnant women (Group 1; n=182) and one group of recurrent aborters (Group 2; n=127) were evaluated, including demographic, medical, clinical, and serological data. RESULTS AND CONCLUSIONS The mean age of the two groups was 27.1 and 28.2 years, respectively. The mean number of deliveries was low (0.4 and 0.5, respectively). Thirty-one point six percent of Group 1 and 41.9% of Group 2 were daily smokers. The group of normally pregnant women had a significantly increased frequency of induced abortions compared to the recurrent aborters, while the recurrent aborters reported more genital infections. There was little difference in total antibodies to cytomegalovirus (CMV) (78.0% and 81.1%, respectively) or B19 IgG (75.3% and 66.9%, respectively) between the groups, while the normal pregnant women had a significantly higher prevalence of rubella antibodies (77.5% and 59.8%, respectively). Our results indicate that less women remain susceptible to primary CMV infection in pregnancy in Russia compared to western Europe and North America. The prevalence of B19 IgG was slightly lower than data from Sweden. Natural immunization against rubella virus was lower than in other, unvaccinated female populations. Vaccination strategies for rubella are now initiated in the Russian Federation. Results from this study are utilized in a federally supported, comprehensive pregnancy care project of North-West Russia.
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Affiliation(s)
- J Ø Odland
- Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway.
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Jensen IP, Thorsen P, Jeune B, Møller BR, Vestergaard BF. An epidemic of parvovirus B19 in a population of 3,596 pregnant women: a study of sociodemographic and medical risk factors. BJOG 2000; 107:637-43. [PMID: 10826579 DOI: 10.1111/j.1471-0528.2000.tb13306.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To estimate the incidence of human parvovirus B19 among pregnant women before and during an epidemic, to elucidate possible sociodemographic and medical risk factors during pregnancy and to estimate the association between parvovirus B19 infection and negative pregnancy outcome. DESIGN Prospective study among pregnant women followed from their first antenatal visit before 24 full weeks of gestation until delivery. SETTING Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark, November 1992 to February 1994. METHODS 3,596 pregnant women were invited to participate. The women were examined at first antenatal visit in the period from November 1992 to February 1994 and at delivery. The last delivery was in August 1994 and samples were thus collected before and during a large parvovirus B19 epidemic in Denmark January to September 1994. A blood sample for parvovirus B19 serology was taken at enrollment and from the umbilical cord at delivery. Three questionnaires were completed during 2nd and 3rd trimesters and a registration form at delivery. In total, 3,174 (87.6%) were enrolled and 79.5% completed the study. RESULTS The prevalence of B19 IgG seropositivity at the first antenatal visit before 24 full weeks of gestation was 66% . The cumulative prevalence proportion of acute parvovirus B19 infection during pregnancy among IgG negative women was found to be 10.3% (IgM seropositivity and/or IgG seroconversion). The IgG seroconversion incidence increased significantly from 1.0% to 13.5% among 932 seronegative pregnant women before and during the epidemic, respectively (P < 0.001). Independent risk factors related to increased risk of B19 infection during pregnancy, adjusted for other sociodemographic and medical factors, were: children at home (adjusted OR 2.1, 95% CI 1.3-3.2); serious medical disease (adjusted OR 3.0, 95% CI 1.0-8.5); and a stressful job (adjusted OR 1.8, 95% CI 1.0-3.3). Parvovirus B 19 IgM seropositivity was associated with events of late spontaneous abortions and stillbirths (crude OR 9.9; 95% CI 3.3-29.4). CONCLUSION Before and during an epidemic of acute B19 infection incidences were measured among pregnant women to be 1.0% and 13.5%, respectively. Three factors, significantly increasing the risk of acute B19, were identified as: having children at home; suffering from serious medical diseases; and having a stressful job. IgM positivity for parvovirus B19 was associated with negative outcome of pregnancy.
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Affiliation(s)
- I P Jensen
- Department of Virology, States Serum Institute, Copenhagen, Denmark
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Skjöldebrand-Sparre L, Tolfvenstam T, Papadogiannakis N, Wahren B, Broliden K, Nyman M. Parvovirus B19 infection: association with third-trimester intrauterine fetal death. BJOG 2000; 107:476-80. [PMID: 10759265 DOI: 10.1111/j.1471-0528.2000.tb13265.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To identify the presence of parvovirus B19 infection as a possible cause of fetal loss in the third trimester. DESIGN Prospective study of women experiencing third-trimester intrauterine fetal death (IUFD). SETTING All cases of IUFD at Danderyd Hospital from 1992 to 1998. POPULATION Ninety-three women with IUFD in 33,759 deliveries (0.3%). METHODS Detection of B19 DNA by polymerase chain reaction (PCR) in placental and fetal tissue. Placental pathology and B19-specific immunohistochemistry. Maternal serology in consecutive samples. RESULTS Among 93 cases of IUFD, seven (7.5%) had detectable B19 DNA in freshly-frozen placental tissue. The detection of B19 DNA in these tissues was confirmed by detection of B19 DNA in six separately stored paraffin-embedded placental tissues. No other explanations for the fetal deaths were found. None of the women had experienced any clinical signs of infection prior to fetal demise. None of the seven fetuses were hydropic. Histopathologic examination of the placentas revealed only minor abnormalities. Serology on maternal samples at birth revealed delayed or absent B19 IgG responses in five of seven cases. Two women were B19 IgG seropositive at the time of delivery but had unusual infection patterns; persistent viraemia for at least five months before birth in one case and likely persistence or re-infection by B19 in the other. CONCLUSION In our study, 7.5% of IUFDs in the third trimester may have been caused by parvovirus B19 infection, without signs of fetal hydrops. This finding indicates that B19 PCR should be included in the routine investigation of IUFD.
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Affiliation(s)
- L Skjöldebrand-Sparre
- Division of Obstetrics and Gynaecology, Karolinska Institutet, Danderyd Hospital, Sweden
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Maksheed M, Pacsa AS, Essa SS, Ahmed MA, Monem RA, Surkouh M. The prevalence of antibody to human parvovirus B19 in pregnant women in Kuwait. Acta Trop 1999; 73:225-9. [PMID: 10546839 DOI: 10.1016/s0001-706x(99)00033-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infection with parvovirus B19 during pregnancy is known to be associated with various fetal damage, such as aplastic anemia and hydrops fetalis. Our objective was to study the seroprevalence of parvovirus B19 in the obstetric population in Kuwait and to compare this with that in the adult population in other regions. Blood samples from 1047 pregnant women were used in this prospective study. Information regarding patient's age, parity, nationality and symptoms was obtained at the time of collection of the sample. Blood was tested for IgG and IgM antibodies specific for parvovirus B19 using the ELISA technique. The overall prevalence for IgG and IgM was 53.3 and 2.2%, respectively. IgG seropositivity was higher in non-Kuwaiti women, while IgM antibodies was more frequent in Kuwaiti women. A total of 17.4% of the acutely infected patients were symptomatic. Prevalence of parvovirus B19 infection in Kuwait is comparable with that in the other countries.
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Affiliation(s)
- M Maksheed
- Department of Obstetrics and Gynaeology, Faculty of Medicine, Kuwait University, Safat.
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Affiliation(s)
- B Barton Rogers
- Department of Pathology, Children's Medical Center and The University of Texas Southwestern Medical School, 1935 Motor Street, Dallas, TX 75235, USA
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Skjöldebrand-Sparre L, Nyman M, Broliden K, Wahren B. All cases of intrauterine fetal death should be evaluated for parvovirus B19 viral deoxyribonucleic acid. Am J Obstet Gynecol 1999; 180:1595-6. [PMID: 10368510 DOI: 10.1016/s0002-9378(99)70059-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Makhseed M, Pacsa A, Ahmed MA, Essa SS. Pattern of parvovirus B 19 infection during different trimesters of pregnancy in Kuwait. Infect Dis Obstet Gynecol 1999; 7:287-92. [PMID: 10598918 PMCID: PMC1784763 DOI: 10.1002/(sici)1098-0997(1999)7:6<287::aid-idog7>3.0.co;2-m] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Aims of this study were to determine the IgG and IgM seropositivity to parvovirus B19 during the three trimesters of pregnancy. METHODS Initially, a total of 1,047 pregnant women were included in a prospective study. Blood samples were obtained from 343, 406 and 298 cases in the first, second and third trimesters, respectively. To study the incidence of seroconversion, a second sample of blood was obtained 2-4 weeks later from the first 100 cases, who were IgG and IgM negative in the first trimester. RESULTS The seroprevalence of parvovirus B19 IgG and IgM was 53.3% and 2.2%, respectively. The incidence of seroconversion was 16.5%. The rate of fetal loss was 15.4% in patients with acute infection, all of which occurred in the first two trimesters. CONCLUSIONS The percentage of IgG positive cases is significantly higher in first and second trimesters compared to the third trimester. The seroconversion rate was 16.5%.
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Affiliation(s)
- M Makhseed
- Department of Obstetrics and Gynaecology, Kuwait University.
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Jensen IP, Schou O, Vestergaard BF. The 1994 human parvovirus B19 epidemic in Denmark: diagnostic and epidemiological experience. APMIS 1998; 106:843-8. [PMID: 9808410 DOI: 10.1111/j.1699-0463.1998.tb00230.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In 1994 the first human parvovirus B19 (B19) epidemic to be documented in Denmark was recorded from February 2 to September 30. In total, 10,333 serum samples were tested for specific B19 IgM and IgG antibodies, using IDEIA Parvovirus B19 IgM and IgG kits. The prevalence of B19 IgM positivity was 11% for the whole period and 29% at the peak of the epidemic in week 14, declining from week 39 and onwards to 1-3%. The prevalence of B19 IgG (IgM-negative samples) was 60%, indicating an earlier infection, and the same for men and women. The gender distribution of tested patients was the same at the beginning of the epidemic as at the end of the epidemic and a year after its peak, i.e. 86% of samples were from women and only 14% from men. Age distribution for women was the same for the three periods (median age 34 years). For men the median age was 32 years, 39 years and 31 years, respectively. Only a few samples from children were tested. No change in test pattern was observed during the three periods. Approximately 75% of all samples tested were from women of childbearing age (18-45 years old), suggesting a fear of fetal complications in an actual or future pregnancy, rather than a serological verification of clinical symptoms. From the sparse clinical information that accompanied the serum sample we were not able to demonstrate that women were more likely than men to have a symptomatic B19 infection. With reservations we estimate that 14% of adverse pregnancy outcome is correlated with a B19 infection.
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Affiliation(s)
- I P Jensen
- Department of Virology, Statens Serum Institut, Copenhagen, Denmark
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Yaegashi N, Niinuma T, Chisaka H, Watanabe T, Uehara S, Okamura K, Moffatt S, Sugamura K, Yajima A. The incidence of, and factors leading to, parvovirus B19-related hydrops fetalis following maternal infection; report of 10 cases and meta-analysis. J Infect 1998; 37:28-35. [PMID: 9733374 DOI: 10.1016/s0163-4453(98)90346-2] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES to clarify the approximation of the frequency of B19-related nonimmune hydrops fetalis (NIHF), and to know the critical period during which maternal infection led to NIHF. METHODS we investigated the characteristics of 10 cases of antenatal B19 infection diagnosed over the past 10 years in Miyagi prefecture, Japan, and performed a meta-analysis of these cases and those previously reported in the literature. RESULTS NIHF caused by intrauterine B19 infection was diagnosed between 11 and 23 weeks of gestation in 10 women over the past 10 years in Miyagi prefecture, Japan. The source of infection was the mother's older child in six out of 10 cases, and children at a kindergarten where the mothers worked in two cases. The interval between the onset of infection and the diagnosis of NIHF ranged from 2 to 6 weeks. B19 infection was responsible for 10 (15.2%) in 66 cases of aetiology unknown NIHF in this study, and for 57 (19.1%) of 299 cases of non-malformed or aetiology-unknown NIHF by meta-analysis of the literature. Meta-analysis of the 165 reported cases of antenatal B19 infection, including the 10 cases described above, showed that there was a 10.2% excess risk of fetal death in women infected with B19 during pregnancy and a 12.40% excess risk in women infected during the first 20 weeks of pregnancy. Transplacental transmission was confirmed in 69 (24.1%) of 286 cases. The mean gestational age at diagnosis of NIHF was 22.8 +/- 5.1 weeks. The mean interval between the onset of maternal infection and diagnosis of NIHF was 6.2 +/- 3.7 weeks. CONCLUSIONS these approximations will be useful for counselling and management for pregnant women. The critical period during which maternal infection led to NIHF correlated with the hepatic period of hematopoietic activity. These findings suggest that parvovirus B19 may have an affinity for erythroid lineage cells at the hepatic stage of hematopoiesis, which may strongly influence the clinical features of feto-maternal B19 infection.
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Affiliation(s)
- N Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan
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