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Published on: June 24, 2020
The perinatal health challenges of emerging and re-emerging infectious diseases: A narrative review
Veronica N E Malange1, Gitte Hedermann1,2, Ulrik Lausten-Thomsen3
1Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark.
Insights
Infectious disease outbreaks pose significant risks to perinatal health, leading to preterm birth and low birth weight. Systematic data collection on pregnancy outcomes during outbreaks is crucial for updating care protocols.
Area of Science:
- Perinatal Health
- Infectious Disease Epidemiology
- Public Health Surveillance
Background:
- Infectious disease outbreaks have demonstrated considerable perinatal health consequences, including increased risks of preterm delivery and low birth weight infants.
- Severe outcomes such as perinatal and infant death are known consequences of various infectious diseases.
- Existing transmission-control methods offer some protection, but data on pregnancy impacts are often delayed or scarce.
Purpose of the Study:
- To highlight the significant delay in reporting perinatal impacts of infectious disease outbreaks.
- To underscore the lack of systematic pregnancy data collection during outbreaks.
- To emphasize the need for integrated perinatal health monitoring in disease surveillance.
Main Methods:
- Review of scientific literature on infectious disease outbreaks between 2010 and 2020.
- Analysis of reporting timelines for perinatal health consequences.
- Assessment of data availability concerning pregnant women and unborn infants during outbreaks.
Main Results:
- A significant lag of nearly two years exists before the perinatal impacts of outbreaks are reported.
- Many outbreaks between 2010-2020 lack associated pregnancy data or report it only through case studies.
- This data gap hinders understanding of disease implications for maternal-fetal health.
Conclusions:
- Systematic collection and reporting of perinatal health data during infectious disease outbreaks are essential.
- Integrating perinatal health monitoring into disease surveillance is critical for timely updates to pregnancy care protocols.
- Proactive assessment of pregnancy and perinatal health is necessary alongside outbreak response efforts.
Abstract:
The world has seen numerous infectious disease outbreaks in the past decade. In many cases these outbreaks have had considerable perinatal health consequences including increased risk of preterm delivery (e.g., influenza, measles, and COVID-19), and the delivery of low birth weight or small for gestational age babies (e.g., influenza, COVID-19). Furthermore, severe perinatal outcomes including perinatal and infant death are a known consequence of multiple infectious diseases (e.g., Ebola virus disease, Zika virus disease, pertussis, and measles). In addition to vaccination during pregnancy (where possible), pregnant women, are provided some level of protection from the adverse effects of infection through community-level application of evidence-based transmission-control methods. This review demonstrates that it takes almost 2 years for the perinatal impacts of an infectious disease outbreak to be reported. However, many infectious disease outbreaks between 2010 and 2020 have no associated pregnancy data reported in the scientific literature, or pregnancy data is reported in the form of case-studies only. This lack of systematic data collection and reporting has a negative impact on our understanding of these diseases and the implications they may have for pregnant women and their unborn infants. Monitoring perinatal health is an essential aspect of national and global healthcare strategies as perinatal life has a critical impact on early life mortality as well as possible effects on later life health. The unpredictable nature of emerging infections and the potential for adverse perinatal outcomes necessitate that we thoroughly assess pregnancy and perinatal health implications of disease outbreaks and their public health interventions in tandem with outbreak response efforts. Disease surveillance programs should incorporate perinatal health monitoring and health systems around the world should endeavor to continuously collect perinatal health data in order to quickly update pregnancy care protocols as needed.
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