Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Mar 31;11(3):e0152015.
doi: 10.1371/journal.pone.0152015. eCollection 2016.

Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy

Helen Y Chu  1 , Joanne Katz  2 , James Tielsch  3 , Subarna K Khatry  4 , Laxman Shrestha  5 , Steven C LeClerq  4 , Amalia Magaret  6   7 , Jane Kuypers  6 , Mark C Steinhoff  8 , Janet A Englund  9
Affiliations
Randomized Controlled Trial

Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy

Helen Y Chu et al. PLoS One. .

Abstract

Background: Respiratory syncytial virus (RSV) is the most important cause of viral pneumonia in children worldwide. A maternal vaccine may protect both the mother and infant from RSV illness. The epidemiology and clinical presentation of RSV in pregnant and postpartum women is not well-described.

Methods: Data were collected from a prospective, randomized trial of influenza immunization in pregnant women in rural southern Nepal. Women were enrolled in their second trimester of pregnancy and followed until six months postpartum. Active weekly home-based surveillance for febrile respiratory illness was performed. Mid-nasal swabs collected with episodes of respiratory illness were tested for RSV by real-time polymerase chain reaction.

Results: RSV was detected in 14 (0.4%) illness episodes in 3693 women over 3554 person-years of surveillance from 2011-2014. RSV incidence was 3.9/1000 person-years overall, and 11.8/1000 person-years between September and December. Seven (50%) women sought care for RSV illness; none died. Of the 7 (50%) illness episodes during pregnancy, all had live births with 2 (29%) preterm births and a median birthweight of 3060 grams. This compares to 469 (13%) preterm births and a median birthweight of 2790 grams in women without RSV during pregnancy. Of the 7 mothers with postpartum RSV infection, RSV was detected in 4 (57%) of their infants.

Conclusions: RSV was an uncommon cause of febrile respiratory illness in mothers during pregnancy in Nepal. These data will inform prevention and therapeutic strategies against RSV in resource-limited settings.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: JAE has received research support from Gilead, Chimerix, GlaxoSmithKline, and Roche, has received payment for lectures from Abbvie, and serves as a consultant for GlaxoSmithKline and Gilead. HYC has received research support from GlaxoSmithKline. MS serves on the board of the Novartis Vaccine Institute for Global Health. AM consults for AiCuris. All other authors declare no conflicts of interest. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow diagram of study participants.
Study participants were monitored with weekly active home-based surveillance for febrile respiratory illness over three years.
Fig 2
Fig 2. Heatmap of symptoms in women with respiratory syncytial virus infection.
Heatmap with symptoms in women with respiratory syncytial virus infection during pregnancy (top) and after delivery (bottom) over the duration of the illness episodes. The color intensity of the box represents the number of participants with symptoms, with each box representing one day.
See this image and copyright information in PMC

References

    1. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375(9725):1545–55. 10.1016/S0140-6736(10)60206-1 - DOI - PMC - PubMed
    1. Chu HY, Englund JA. Maternal Immunization. Clin Infect Dis. 2014. - PMC - PubMed
    1. Glenn GM, Fries LF, Thomas DN, Smith G, Kpamegan E, Lu H, et al. A Randomized, Blinded, Controlled, Dose-Ranging Study of a Respiratory Syncytial Virus Recombinant Fusion (F) Nanoparticle Vaccine in Healthy Women of Childbearing Age. J Infect Dis. 2015. - PubMed
    1. Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. Am J Obstet Gynecol. 2012;207(3 Suppl):S3–8. 10.1016/j.ajog.2012.06.068 - DOI - PubMed
    1. Zaman K, Roy E, Arifeen SE, Rahman M, Raqib R, Wilson E, et al. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med. 2008;359(15):1555–64. 10.1056/NEJMoa0708630 - DOI - PubMed

Publication types

MeSH terms