OBJECTIVE: To determine the role of viral infections in causing fetal and infant death. STUDY DESIGN: We assessed a well-validated population database of fetal (≥20 weeks gestation) and infant death for infective deaths and deaths from viruses over a 21-year period (1988-2008). We analyzed by specific viral cause, timing (late fetal loss [20-23 weeks], stillbirth [≥24 weeks], neonatal death [0-27 days], and post-neonatal infant death [28-364 days]) and across time. RESULTS: Of the 989 total infective deaths, 108 were attributable to viral causes (6.5% of late fetal losses, 14.5% of stillbirths, 6.5% of neonatal deaths, and 19.4% of postneonatal infant deaths). Global loss (combined fetal and infant losses per 100,000 registerable births) was 139.6 (95% CI, 130.9-148.3) for any infective cause and 15.2 (95% CI, 12.3-18.1) for viral infections. More than one-third (37%) of viral-attributed deaths were before live birth, from parvovirus (63%) or cytomegalovirus (33%). Parvovirus accounted for 26% (28 of 108) of all viral deaths. Cytomegalovirus was associated with a global loss rate of 3.1 (95% CI, 1.8-4.4) and an infant mortality rate of 1.3 (95% CI, 0.4-2.1) per 100,000 live births; 91% of cases were congenital infections. Herpes simplex virus caused death only after live births (infant mortality rate, 1.4; 95% CI, 0.5-2.3). No changes in rates were seen over time. CONCLUSION: We have identified a substantial contribution of viral infections to global fetal and infant losses. More than one-third of these losses occurred before live births. Considering our methodology, our estimates represent the minimum contribution of viral illness. Strategies to reduce this burden are needed.
OBJECTIVE: To determine the role of viral infections in causing fetal and infant death. STUDY DESIGN: We assessed a well-validated population database of fetal (≥20 weeks gestation) and infant death for infective deaths and deaths from viruses over a 21-year period (1988-2008). We analyzed by specific viral cause, timing (late fetal loss [20-23 weeks], stillbirth [≥24 weeks], neonatal death [0-27 days], and post-neonatal infant death [28-364 days]) and across time. RESULTS: Of the 989 total infective deaths, 108 were attributable to viral causes (6.5% of late fetal losses, 14.5% of stillbirths, 6.5% of neonatal deaths, and 19.4% of postneonatal infant deaths). Global loss (combined fetal and infant losses per 100,000 registerable births) was 139.6 (95% CI, 130.9-148.3) for any infective cause and 15.2 (95% CI, 12.3-18.1) for viral infections. More than one-third (37%) of viral-attributed deaths were before live birth, from parvovirus (63%) or cytomegalovirus (33%). Parvovirus accounted for 26% (28 of 108) of all viral deaths. Cytomegalovirus was associated with a global loss rate of 3.1 (95% CI, 1.8-4.4) and an infant mortality rate of 1.3 (95% CI, 0.4-2.1) per 100,000 live births; 91% of cases were congenital infections. Herpes simplex virus caused death only after live births (infant mortality rate, 1.4; 95% CI, 0.5-2.3). No changes in rates were seen over time. CONCLUSION: We have identified a substantial contribution of viral infections to global fetal and infant losses. More than one-third of these losses occurred before live births. Considering our methodology, our estimates represent the minimum contribution of viral illness. Strategies to reduce this burden are needed.
Authors: Enny S Paixão; Maria da Conceição N Costa; Maria Glória Teixeira; Katie Harron; Marcia Furquim de Almeida; Mauricio L Barreto; Laura C Rodrigues Journal: Lancet Infect Dis Date: 2017-09 Impact factor: 25.071
Authors: Iara M Backes; Brook K Byrd; Matthew D Slein; Chaya D Patel; Sean A Taylor; Callaghan R Garland; Scott W MacDonald; Alejandro B Balazs; Scott C Davis; Margaret E Ackerman; David A Leib Journal: J Exp Med Date: 2022-09-26 Impact factor: 17.579
Authors: Alison J Carey; Jennifer L Hope; Yvonne M Mueller; Adam J Fike; Ogan K Kumova; David B H van Zessen; Eric A P Steegers; Mirjam van der Burg; Peter D Katsikis Journal: Front Immunol Date: 2017-12-19 Impact factor: 7.561
Authors: Elizabeth M McClure; Sarah Saleem; Shivaprasad S Goudar; Sangappa Dhaded; G Guruprasad; Yogesh Kumar; Shiyam Sunder Tikmani; Masood Kadir; Jamal Raza; Haleema Yasmin; Janet L Moore; Jean Kim; Carla Bann; Lindsay Parlberg; Anna Aceituno; Waldemar A Carlo; Robert M Silver; Laura Lamberti; Janna Patterson; Robert L Goldenberg Journal: Reprod Health Date: 2018-06-22 Impact factor: 3.223