Two Cases of Q Fever in Pregnancy, including Management of the Newborn, Australia

Optimal management of the birthing parent with Q fever in pregnancy and of the infant has not been established. Coxiella burnetii expresses a tropism for the placenta; resulting infection can potentially lead to spontaneous abortion and fetal demise. Although evidence around preventing transmission and infection in the peripartum and postpartum period is lacking, reports of healthy babies born to mothers with acute or chronic Q fever in pregnancy are increasing. Historically, many clinicians have recommended against breastfeeding in this setting because of a theoretical risk for bacterial transmission through breastmilk. We discuss 2 women in Australia who had Q fever in pregnancy, focusing on the peripartum period and infant management. Breastfeeding was encouraged in both cases. Both infants were born healthy and at term and have demonstrated no serologic or clinical evidence of Q fever infection in the first year of life.