Acute febrile illness in pregnancy: Spectrum of disease and impact on maternal and foetal outcome

Abstract

Acute febrile illness (AFI) in pregnancy is a neglected cause of maternal and foetal mortality and morbidity in low-and middle-income countries. This prospective cohort studied antenatal and postpartum women admitted with acute fever to a tertiary care university teaching hospital from July 2014 to March 2015 for aetiology, maternal and foetal complications, and the impact on maternal mortality ratio (MMR) and perinatal mortality rate. Among the 180 women admitted with AFI, urinary tract infection 54(30%) was the commonest cause, followed by airborne infections (67; 37.2%), peripartum or wound infections (25; 13.8%) and vector-borne diseases (21; 11.6%). Maternal deaths were 4 (2%) and foetal deaths 9 (5%). Post-operative gram-negative sepsis was the most common cause of maternal mortality. The MMR was ten times higher with AFI 2778 against 197 (p < 0.0001) among the other hospital deliveries during the same period. Screening for asymptomatic bacteriuria , maintaining aseptic precautions, and vaccination may impact maternal and foetal morbidity significantly.

Keywords

Acute febrile illness maternal mortality rate foetal outcome

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References

Abu-Raya

Michalski

Sadarangani

, et al. Maternal immunological adaptation during normal pregnancy. Front Immunol 2020; 11: 575197.

Egloff

Sibiude

Couffignal

, et al. Causes and consequences of fever during pregnancy: a retrospective study in a gynaecological emergency department. J Gynecol Obstet Hum Reprod 2020; 49: 101899.

Brar

Suri

, et al. Fever during pregnancy: etiology and fetomaternal outcomes. J Obstet Gynaecol India 2022; 72: 102–108.

Chansamouth

Thammasack

Phetsouvanh

, et al. The aetiologies and impact of fever in pregnant inpatients in Vientiane, laos. PLoS Negl Trop Dis 2016; 10: e0004577.

Chrispal

Boorugu

Gopinath

, et al. Acute undifferentiated febrile illness in adult hospitalized patients: the disease spectrum and diagnostic predictors - an experience from a tertiary care hospital in south India. Trop Doct 2010; 40: 230–234.

Artero

Alberola

Eiros

, et al.

Pyelonephritis in pregnancy. How adequate is empirical treatment?

Rev Espanola Quimioter Publicacion of Soc Espanola Quimioter 2013; 26: 30–33.

Goodnight

Soper

. Pneumonia in pregnancy. Crit Care Med 2005; 33: S390–S397.

Bhalerao-Gandhi

Chhabra

Arya

, et al. Influenza and pregnancy: a review of the literature from India. Infect Dis Obstet Gynecol [Internet] 2015; 2015. Available at: https://pubmed.ncbi.nlm.nih.gov/25810687/.

Charrier

Serafini

Ribatti

, et al. Post-partum surgical wound infections: incidence after caesarean section in an Italian hospital. J Prev Med Hyg 2009; 50: 159–163.

10.

Iyengar

. Early postpartum maternal morbidity among rural women of Rajasthan, India: a community-based study. J Health Popul Nutr 2012; 30: 213–225.

11.

Jaiyeoba

. Postoperative infections in obstetrics and gynecology. Clin Obstet Gynecol 2012; 55: 904.

12.

Kaafarani

Rattan

, et al. Sepsis 2019: what surgeons need to know. Surg Infect 2020; 21: 195–204.

13.

Mathews

George

Mathews

, et al. The Griess test: an inexpensive screening test for asymptomatic bacteriuria in pregnancy. Aust N Z J Obstet Gynaecol 1998; 38: 407–410.

14.

Robertson

Duff

. The nitrite and leukocyte esterase tests for the evaluation of asymptomatic bacteriuria in obstetric patients. Obstet Gynecol 1988; 71: 878–881.

15.

Rajan

Sathyendra

Mathuram

. Scrub typhus in pregnancy: maternal and fetal outcomes. Obstet Med 2016; 9: 164–166.

16.

Mertz

Geraci

Winkup

, et al. Pregnancy as a risk factor for severe outcomes from influenza virus infection: a systematic review and meta-analysis of observational studies. Vaccine 2017; 35: 521–528.