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Ebola virus disease and pregnancy: A review of the current knowledge of Ebola virus pathogenesis, maternal, and neonatal outcomes.

Abstract The 2014 to 2016 Ebola virus disease (EVD) outbreak in West Africa devastated local health systems and caused thousands of deaths. Historical reports from Zaire ebolavirus outbreaks suggested pregnancy was associated with an increased risk of severe illness and death, with mortality rates from 74 to 100%. In total, 111 cases of pregnant patients with EVD are reported in the literature, with an aggregate maternal mortality of 86%. Pregnancy-specific data published from the recent outbreak include four small descriptive cohort studies and five case reports. Despite limitations including reporting bias and small sample size, these studies suggest mortality in pregnant women may be lower than previously reported, with five of 13 (39%) infected women dying. Optimal treatments for pregnant women, and differences in EVD course between pregnant women and nonpregnant individuals, are major scientific gaps that have not yet been systematically addressed. Ebola virus may be transmitted from mother to baby in utero, during delivery, or through contact with maternal body fluids after birth including breast milk. EVD is almost universally fatal to the developing fetus, and limited fetal autopsy data prevent inferences on risk of birth defects. Decisions about delivery mode and other obstetric interventions should be individualized. WHO recommends close monitoring of survivors who later become pregnant, but does not recommend enhanced precautions at subsequent delivery. Although sexual transmission of Ebola virus has been documented, birth outcomes among survivors have not been published and will be important to appropriately counsel women on pregnancy outcomes and inform delivery precautions for healthcare providers. Birth Defects Research 109:353-362, 2017. © 2017 Wiley Periodicals, Inc.
PMID
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Authors

Mayor MeshTerms
Keywords

birth

ebola

fetus

hemorrhagic

outcomes

pregnancy

pregnant

sexually

transmission

women

Journal Title birth defects research
Publication Year Start




PMID- 28398679
OWN - NLM
STAT- In-Data-Review
DA  - 20170411
LR  - 20170413
IS  - 2472-1727 (Electronic)
VI  - 109
IP  - 5
DP  - 2017 Mar 15
TI  - Ebola virus disease and pregnancy: A review of the current knowledge of Ebola
      virus pathogenesis, maternal, and neonatal outcomes.
PG  - 353-362
LID - 10.1002/bdra.23558 [doi]
AB  - The 2014 to 2016 Ebola virus disease (EVD) outbreak in West Africa devastated
      local health systems and caused thousands of deaths. Historical reports from
      Zaire ebolavirus outbreaks suggested pregnancy was associated with an increased
      risk of severe illness and death, with mortality rates from 74 to 100%. In total,
      111 cases of pregnant patients with EVD are reported in the literature, with an
      aggregate maternal mortality of 86%. Pregnancy-specific data published from the
      recent outbreak include four small descriptive cohort studies and five case
      reports. Despite limitations including reporting bias and small sample size,
      these studies suggest mortality in pregnant women may be lower than previously
      reported, with five of 13 (39%) infected women dying. Optimal treatments for
      pregnant women, and differences in EVD course between pregnant women and
      nonpregnant individuals, are major scientific gaps that have not yet been
      systematically addressed. Ebola virus may be transmitted from mother to baby in
      utero, during delivery, or through contact with maternal body fluids after birth 
      including breast milk. EVD is almost universally fatal to the developing fetus,
      and limited fetal autopsy data prevent inferences on risk of birth defects.
      Decisions about delivery mode and other obstetric interventions should be
      individualized. WHO recommends close monitoring of survivors who later become
      pregnant, but does not recommend enhanced precautions at subsequent delivery.
      Although sexual transmission of Ebola virus has been documented, birth outcomes
      among survivors have not been published and will be important to appropriately
      counsel women on pregnancy outcomes and inform delivery precautions for
      healthcare providers. Birth Defects Research 109:353-362, 2017. (c) 2017 Wiley
      Periodicals, Inc.
CI  - (c) 2017 Wiley Periodicals, Inc.
FAU - Bebell, Lisa M
AU  - Bebell LM
AD  - Department of Infectious Diseases, Massachusetts General Hospital, Boston,
      Massachusetts.
AD  - Massachusetts General Hospital Center for Global Health, Boston, Massachusetts.
FAU - Oduyebo, Titilope
AU  - Oduyebo T
AD  - Division of Reproductive Health, National Center for Chronic Disease Prevention
      and Health Promotion, Centers for Disease Control and Prevention, Atlanta,
      Georgia.
AD  - Epidemic Intelligence Service, Centers for Disease Control and Prevention,
      Atlanta, Georgia.
FAU - Riley, Laura E
AU  - Riley LE
AD  - Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, 
      Massachusetts.
LA  - eng
GR  - T32 AI007433/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Birth Defects Res
JT  - Birth defects research
JID - 101701004
OTO - NOTNLM
OT  - birth
OT  - ebola
OT  - fetus
OT  - hemorrhagic
OT  - outcomes
OT  - pregnancy
OT  - pregnant
OT  - sexually
OT  - transmission
OT  - women
EDAT- 2017/04/12 06:00
MHDA- 2017/04/12 06:00
CRDT- 2017/04/12 06:00
PHST- 2016/04/08 [received]
PHST- 2016/06/30 [revised]
PHST- 2016/07/28 [accepted]
AID - 10.1002/bdra.23558 [doi]
PST - ppublish
SO  - Birth Defects Res. 2017 Mar 15;109(5):353-362. doi: 10.1002/bdra.23558.

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