Measles in pregnant women: A systematic review of clinical outcomes and a meta-analysis of antibodies seroprevalence

•Measles infection in pregnancy may be a serious occurrence for mother and fetuses.•The pooled global seroprevalence of measles in gravid women is 89% (95% CI: 87–91%).•Pneumonia is the most frequent complication of measles infection in pregnant women.•Prematurity is the most relevant consequence of...

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Bibliographic Details
Published in:The Journal of infection 2020-02, Vol.80 (2), p.152-160
Main Authors: Congera, Paola, Maraolo, Alberto Enrico, Parente, Serena, Schiano Moriello, Nicola, Bianco, Vincenzo, Tosone, Grazia
Format: Article
Language:English
Subjects:
Antibodies
Delivery
Female
Humans
Maternal outcome
Measles
Measles - epidemiology
Meta-analysis
Pregnancy
Pregnancy Complications, Infectious - epidemiology
Pregnant Women
Seroepidemiologic Studies
Systematic review
Women
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Summary:•Measles infection in pregnancy may be a serious occurrence for mother and fetuses.•The pooled global seroprevalence of measles in gravid women is 89% (95% CI: 87–91%).•Pneumonia is the most frequent complication of measles infection in pregnant women.•Prematurity is the most relevant consequence of measles as for the fetuses. Pregnant women represent a category at high risk of severe measles infection, that negatively affects the fetus as well. A systematic review of clinical outcomes of measles infection in gravid subjects and a meta-analysis of antibodies prevalence among pregnant women was conducted. MEDLINE and EMBASE databases were searched up to 18 June 2018. The screening focused on: (i) articles describing the outcome of measles in pregnancy, synthesized in a descriptive fashion; (ii) articles addressing the measles seroprevalence in cohorts of gravid women, analysed quantitatively. Twenty-nine articles met inclusion criteria. A total of 420 cases of measles in gravid subjects were described, from 1941 to 2012. Among women, 18 deaths (4.3%) occurred, and the most frequent complication was pneumonia (75/420, 17.9%). Prematurity was the most important complication concerning fetal outcomes (55 out of 410 cases with available data, 13.4%). The random-effects pooled seroprevalence of measles in 20,546 gravid women worldwide was 89.3% (95% CI: 87.3–91.1%), that decreased, although not in a statistically significant way, over time (p = 0.54). Measles infection in pregnancy is dangerous both for the mother and the foetus. Antibody seroprevalence among gravid women on a global scale is lower than the herd immunity threshold.
ISSN:0163-4453
1532-2742
DOI:10.1016/j.jinf.2019.12.012