Pregnancy-related listeriosis in Spain

Abstract

Background: Pregnant women are at high risk of acquiring listeriosis, resulting in severe fetal and neonatal outcomes.

Methods: All hospitalizations with a listeriosis diagnosis in pregnant women (obstetric listeriosis) and/or newborns (neonatal listeriosis) in Spain from 2000 to 2021 were examined using the National Registry of Hospital Discharges, employing ICD-9 and -10 coding lists.

Results: A total of 540 and 450 hospital admissions for obstetric listeriosis and neonatal listeriosis were identified, respectively, with 146 adverse fetal-neonatal outcomes (miscarriage, fetal loss, stillbirth, and neonatal death). The incidence of obstetric listeriosis, neonatal listeriosis, and adverse fetal-neonatal outcomes (5.7, 4.7, and 1.5 per 100,000 deliveries, respectively) rose significantly from 2000 to 2021. No maternal deaths were recorded among women hospitalized with obstetric listeriosis. However, 9.8 % experienced miscarriage, related to bacteremia (OR=2.46), 6.3 % fetal loss and 5.9 % stillbirths, associated with chorioamnionitis (OR=3.42), which was identified in 77.7 % of 254 deliveries. Overall, 51.1 % of newborns developed sepsis, 58.9 % prematurity, 26.9 % ARDS, and 9.8 % died. ARDS (OR=2.76) and prematurity (OR=5.07) were associated with perinatal death in newborns with listeriosis. Pregnancy-related listeriosis was associated with increased risks of miscarriage (OR=1.75), intrauterine death (OR=17), preterm labor (OR=8.78), fetal distress (OR=2.10), cesarean section (OR=1.68), and stillbirth (OR=23.57).

Conclusions: Admissions for obstetric listeriosis and neonatal listeriosis in Spain have risen significantly from 2000 to 2021. Pregnancy-related listeriosis has a deleterious impact on fetal and neonatal outcomes, including miscarriages, fetal loss, stillbirth, and neonatal death. Surveillance, prevention, and prompt management of pregnant women with listeriosis and newborns with neonatal infection are warranted.

Keywords: Fetal loss; Listeriosis; Neonatal; Newborn mortality; Pregnancy; Prematurity.