Viral infections: contributions to late fetal death, stillbirth, and infant death

Williams, Eleri J., Embleton, Nicholas D., Clark, Julia E., Bythell, Mary, Platt, Martin P. Ward and Berrington, Janet E. (2013) Viral infections: contributions to late fetal death, stillbirth, and infant death. Journal of Pediatrics, 163 2: 424-428. doi:10.1016/j.jpeds.2013.02.004

Author Williams, Eleri J.
Embleton, Nicholas D.
Clark, Julia E.
Bythell, Mary
Platt, Martin P. Ward
Berrington, Janet E.
Title Viral infections: contributions to late fetal death, stillbirth, and infant death
Journal name Journal of Pediatrics   Check publisher's open access policy
ISSN 0022-3476
Publication date 2013-08-01
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.jpeds.2013.02.004
Open Access Status Not yet assessed
Volume 163
Issue 2
Start page 424
End page 428
Total pages 5
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Formatted abstract
Objective: To determine the role of viral infections in causing fetal and infant death.

Study design: We assessed a well-validated population database of fetal (≥20 weeks gestation) and infant death for infective deaths and deaths from viruses over a 21-year period (1988-2008). We analyzed by specific viral cause, timing (late fetal loss [20-23 weeks], stillbirth [≥24 weeks], neonatal death [0-27 days], and post-neonatal infant death [28-364 days]) and across time.

Results: Of the 989 total infective deaths, 108 were attributable to viral causes (6.5% of late fetal losses, 14.5% of stillbirths, 6.5% of neonatal deaths, and 19.4% of postneonatal infant deaths). Global loss (combined fetal and infant losses per 100 000 registerable births) was 139.6 (95% CI, 130.9-148.3) for any infective cause and 15.2 (95% CI, 12.3-18.1) for viral infections. More than one-third (37%) of viral-attributed deaths were before live birth, from parvovirus (63%) or cytomegalovirus (33%). Parvovirus accounted for 26% (28 of 108) of all viral deaths. Cytomegalovirus was associated with a global loss rate of 3.1 (95% CI, 1.8-4.4) and an infant mortality rate of 1.3 (95% CI, 0.4-2.1) per 100 000 live births; 91% of cases were congenital infections. Herpes simplex virus caused death only after live births (infant mortality rate, 1.4; 95% CI, 0.5-2.3). No changes in rates were seen over time.

Conclusion: We have identified a substantial contribution of viral infections to global fetal and infant losses. More than one-third of these losses occurred before live births. Considering our methodology, our estimates represent the minimum contribution of viral illness. Strategies to reduce this burden are needed. Copyright
Keyword Congenital cytomegalovirus (CCMV)
Cytomegalovirus (CMV)
Herpes simplex virus (HSV)
Infant mortality rate (IMR)
Perinatal Mortality Survey (PMS)
Termination of pregnancy (TOP)
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 13 times in Thomson Reuters Web of Science Article | Citations
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