TY - JOUR
T1 - Burden of Respiratory Syncytial Virus–Associated Acute Respiratory Infections During Pregnancy
AU - Kenmoe, Sebastien
AU - Chu, Helen Y.
AU - Dawood, Fatimah S.
AU - Milucky, Jennifer
AU - Kittikraisak, Wanitchaya
AU - Matthewson, Hamish
AU - Kulkarni, Durga
AU - Suntarattiwong, Piyarat
AU - Frivold, Collrane
AU - Mohanty, Sarita
AU - Havers, Fiona
AU - Li, You
AU - Nair, Harish
AU - Aerssens, Jeroen
AU - Callendret, Benoit
AU - Ispas, Gabriela
AU - Ahani, Bahar
AU - Atwell, Jessica
AU - Begier, Elizabeth
AU - Turiga, Monica
AU - Htar, Tin Tin
AU - Bangert, Mathieu
AU - Kramer, Rolf
AU - Vernhes, Charlotte
AU - Beutels, Philippe
AU - Bont, Louis
AU - Campbell, Harry
AU - Nair, Harish
AU - Li, You
AU - Kenmoe, Sebastien
AU - Osei-Yeboah, Richard
AU - Wang, Xin
AU - Cohen, Rachel
AU - Santos, Gael Dos
AU - Joosten, Philip
AU - Last, Theo
AU - Kumar, Veena
AU - Machin, Nuria
AU - Nohynek, Hanna
AU - Openshaw, Peter
AU - Paget, John
AU - Pollard, Andrew
AU - Teirlinck, Anne
AU - Urchueguía-Fornes, Arantxa
AU - Mira-Iglesias, Ainara
AU - Orrico-Sánchez, Alejandro
AU - Díez-Domingo, Javier
AU - Klint, Johannesen Caroline
AU - Miller, Mark
AU - Mikolajczyk, Rafael
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.
PY - 2024/3/15
Y1 - 2024/3/15
N2 - Background. With the licensure of maternal respiratory syncytial virus (RSV) vaccines in Europe and the United States, data are needed to better characterize the burden of RSV-associated acute respiratory infections (ARI) in pregnancy. The current study aimed to determine among pregnant individuals the proportion of ARI testing positive for RSV and the RSV incidence rate, RSV-associated hospitalizations, deaths, and perinatal outcomes. Methods. We conducted a systematic review, following PRISMA 2020 guidelines, using 5 databases (Medline, Embase, Global Health, Web of Science, and Global Index Medicus), and including additional unpublished data. Pregnant individuals with ARI who had respiratory samples tested for RSV were included. We used a random-effects meta-analysis to generate overall proportions and rate estimates across studies. Results. Eleven studies with pregnant individuals recruited between 2010 and 2022 were identified, most of which recruited pregnant individuals in community, inpatient and outpatient settings. Among 8126 pregnant individuals, the proportion with ARI that tested positive for RSV ranged from 0.9% to 10.7%, with a meta-estimate of 3.4% (95% confidence interval [CI], 1.9%–54%). The pooled incidence rate of RSV among pregnant individuals was 26.0 (95% CI, 15.8–36.2) per 1000 person-years. RSV hospitalization rates reported in 2 studies were 2.4 and 3.0 per 1000 person-years. In 5 studies that ascertained RSV-associated deaths among 4708 pregnant individuals, no deaths were reported. Three studies comparing RSV-positive and RSV-negative pregnant individuals found no difference in the odds of miscarriage, stillbirth, low birth weight, and small size for gestational age. RSV-positive pregnant individuals had higher odds of preterm delivery (odds ratio, 3.6 [95% CI, 1.3–10.3]). Conclusions. Data on RSV-associated hospitalization rates are limited, but available estimates are lower than those reported in older adults and young children. As countries debate whether to include RSV vaccines in maternal vaccination programs, which are primarily intended to protect infants, this information could be useful in shaping vaccine policy decisions.
AB - Background. With the licensure of maternal respiratory syncytial virus (RSV) vaccines in Europe and the United States, data are needed to better characterize the burden of RSV-associated acute respiratory infections (ARI) in pregnancy. The current study aimed to determine among pregnant individuals the proportion of ARI testing positive for RSV and the RSV incidence rate, RSV-associated hospitalizations, deaths, and perinatal outcomes. Methods. We conducted a systematic review, following PRISMA 2020 guidelines, using 5 databases (Medline, Embase, Global Health, Web of Science, and Global Index Medicus), and including additional unpublished data. Pregnant individuals with ARI who had respiratory samples tested for RSV were included. We used a random-effects meta-analysis to generate overall proportions and rate estimates across studies. Results. Eleven studies with pregnant individuals recruited between 2010 and 2022 were identified, most of which recruited pregnant individuals in community, inpatient and outpatient settings. Among 8126 pregnant individuals, the proportion with ARI that tested positive for RSV ranged from 0.9% to 10.7%, with a meta-estimate of 3.4% (95% confidence interval [CI], 1.9%–54%). The pooled incidence rate of RSV among pregnant individuals was 26.0 (95% CI, 15.8–36.2) per 1000 person-years. RSV hospitalization rates reported in 2 studies were 2.4 and 3.0 per 1000 person-years. In 5 studies that ascertained RSV-associated deaths among 4708 pregnant individuals, no deaths were reported. Three studies comparing RSV-positive and RSV-negative pregnant individuals found no difference in the odds of miscarriage, stillbirth, low birth weight, and small size for gestational age. RSV-positive pregnant individuals had higher odds of preterm delivery (odds ratio, 3.6 [95% CI, 1.3–10.3]). Conclusions. Data on RSV-associated hospitalization rates are limited, but available estimates are lower than those reported in older adults and young children. As countries debate whether to include RSV vaccines in maternal vaccination programs, which are primarily intended to protect infants, this information could be useful in shaping vaccine policy decisions.
KW - disease burden
KW - pregnancy
KW - respiratory syncytial virus
UR - http://www.scopus.com/inward/record.url?scp=85180647049&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiad449
DO - 10.1093/infdis/jiad449
M3 - Article
C2 - 37824420
AN - SCOPUS:85180647049
SN - 0022-1899
VL - 229
SP - S51-S60
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
ER -