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• W2743104675 abstract "Arboviruses are an expanding public health threat, with pregnant women facing unique complications from arbovirus infections. These infections, such as dengue and Crimean–Congo haemorrhagic fever, can be more severe in pregnant women than in the general population. Vertical transmission is reported for many arboviruses and can severely affect pregnancy outcome. Indeed, arboviruses—particularly flaviviruses and alphaviruses—are associated with increased risks of fetal loss and premature birth. Arboviruses can be teratogenic, as is the case for Zika virus and Venezuelan equine encephalitis virus. Finally, intrapartum transmission can result in severe neonatal infections, as is true for chikungunya virus. Although the global burden of arboviruses is well recognised, few studies have provided data on arbovirus infection specifically in the context of maternal and child health. Epidemiological and clinical studies are therefore needed to better assess the burden of arbovirus infections during pregnancy and to improve the prevention and clinical management of these viral infections. In this Review, we analyse the information available and identify gaps in knowledge that require further assessment. Arboviruses are an expanding public health threat, with pregnant women facing unique complications from arbovirus infections. These infections, such as dengue and Crimean–Congo haemorrhagic fever, can be more severe in pregnant women than in the general population. Vertical transmission is reported for many arboviruses and can severely affect pregnancy outcome. Indeed, arboviruses—particularly flaviviruses and alphaviruses—are associated with increased risks of fetal loss and premature birth. Arboviruses can be teratogenic, as is the case for Zika virus and Venezuelan equine encephalitis virus. Finally, intrapartum transmission can result in severe neonatal infections, as is true for chikungunya virus. Although the global burden of arboviruses is well recognised, few studies have provided data on arbovirus infection specifically in the context of maternal and child health. Epidemiological and clinical studies are therefore needed to better assess the burden of arbovirus infections during pregnancy and to improve the prevention and clinical management of these viral infections. In this Review, we analyse the information available and identify gaps in knowledge that require further assessment. Arboviruses are viruses transmitted by arthropod vectors. More than 100 arbovirus species are pathogenic to human beings. They belong to six main RNA virus families (Togaviridae, Flaviviridae, Bunyaviridae, Reoviridae, Rhabdoviridae, and Orthomyxoviridae), and therefore exhibit high genetic variability. Arbovirus infections typically manifest as fever, possibly associated with cutaneous, joint, neurological, or haemorrhagic symptoms and signs. The 2015–16 outbreak of Zika virus and the identification of its teratogenicity illustrate the threat posed by arboviruses to pregnant women and their fetuses; many other arboviruses are associated with maternal and fetal pathologies.1Calvet G Aguiar RS Melo AS et al.Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study.Lancet Infect Dis. 2016; 16: 653-660Summary Full Text Full Text PDF PubMed Scopus (491) Google Scholar All inhabited continents face emerging, re-emerging, or highly endemic arbovirus infections, as highlighted by the recent outbreaks of Zika virus, chikungunya virus (which has spread from Africa to the Indian Ocean, Asia, and the Americas), and West Nile virus (which has spread throughout North America in the past decade); by the increasing burden of dengue virus (1 ×108 cases each year globally); and by the recent re-emergence of yellow fever virus infections (2 × 105 cases each year globally).2Weaver SC Lecuit M Chikungunya virus and the global spread of a mosquito-borne disease.N Engl J Med. 2015; 372: 1231-1239Crossref PubMed Scopus (267) Google Scholar, 3Weaver SC Reisen WK Present and future arboviral threats.Antiviral Res. 2010; 85: 328-345Crossref PubMed Scopus (617) Google Scholar, 4Simmons CP Farrar JJ Nguyen vV Wills B Dengue.N Engl J Med. 2012; 366: 1423-1432Crossref PubMed Scopus (757) Google Scholar Of the estimated 2·1 ×108 annual pregnancies worldwide, 90% occur in areas where arboviruses are endemic or epidemic, while the remaining 10% of pregnant women could be exposed to these viruses sporadically, in view of the increasing number of pregnant travellers.5Singh S Sedgh G Hussain R Unintended pregnancy: worldwide levels, trends, and outcomes.Stud Fam Plann. 2010; 41: 241-250Crossref PubMed Scopus (337) Google Scholar, 6McGready R Ashley EA Wuthiekanun V et al.Arthropod borne disease: the leading cause of fever in pregnancy on the Thai-Burmese border.PLoS Negl Trop Dis. 2010; 4: e888Crossref PubMed Scopus (0) Google Scholar Approximately 10% of pregnant women were estimated to have been infected by chikungunya virus during the 2005–06 outbreak in La Réunion, Brazil, and 2·8% of Brazilian pregnant women had serological evidence of dengue virus infection in the 2008–09 outbreak.7Argolo AF Feres VC Silveira LA et al.Prevalence and incidence of dengue virus and antibody placental transfer during late pregnancy in central Brazil.BMC Infect Dis. 2013; 13: 254Crossref PubMed Scopus (18) Google Scholar, 8Gerardin P Barau G Michault A et al.Multidisciplinary prospective study of mother-to-child chikungunya virus infections on the island of La Reunion.PLoS Med. 2008; 5: e60Crossref PubMed Scopus (0) Google Scholar As of April, 2017, approximately 17 000 pregnant women have been infected by Zika virus in Brazil alone.9PAHOZika—epidemiological report (Brazil).http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=35221&ltemid=270&lang=en%5DDate: 2017Google Scholar Considering that arbovirus infections are under-diagnosed and under-reported in endemic areas, the actual number of infected pregnant women is probably far higher. Arbovirus infections during pregnancy could expose pregnant women to three distinct risks: more severe infection in pregnant women than in the general adult population; mother-to-child transmission before delivery (ie, antepartum transmission), with deleterious consequences on pregnancy and the fetus, including teratogenic effects; and mother-to-child transmission during delivery (intrapartum), resulting in severe neonatal infection. The severity of these potential complications contrasts with the scarcity of available detailed clinical data, and of preventive and curative strategies.10Couderc T Chretien F Schilte C et al.A mouse model for chikungunya: young age and inefficient type-I interferon signaling are risk factors for severe disease.PLoS Pathog. 2008; 4: e29Crossref PubMed Scopus (0) Google Scholar, 11Machado CR Machado ES Rohloff RD et al.Is pregnancy associated with severe dengue? A review of data from the Rio de Janeiro surveillance information system.PLoS Negl Trop Dis. 2013; 7: e2217Crossref PubMed Scopus (27) Google Scholar In this Review, we discuss the available epidemiological, virological, clinical, and therapeutic data on major arbovirus infections in pregnancy and identify gaps in knowledge that need to be addressed (appendix). The main arboviruses causing human diseases are listed in Table 1, Table 2, Table 3. Transmission of human arboviruses involves three factors: a vertebrate reservoir, blood-sucking arthropods that act as biological vectors, and human hosts that can be infected as spillover events and who become a secondary reservoir in urban settings, such as for dengue virus, chikungunya virus, and Zika virus.3Weaver SC Reisen WK Present and future arboviral threats.Antiviral Res. 2010; 85: 328-345Crossref PubMed Scopus (617) Google Scholar, 4Simmons CP Farrar JJ Nguyen vV Wills B Dengue.N Engl J Med. 2012; 366: 1423-1432Crossref PubMed Scopus (757) Google Scholar A wide variety of mosquito, tick, midge, and sandfly species are vectors for arboviruses, although only a few specific vectors are usually implicated for a particular arbovirus.Table 1Classification, maternal risk, and consequences of mother-to-child transmission of major alphavirusesGeographical areaMain vectorsMaternal riskAntenatal consequences of mother-to-child transmissionPerinatal consequences of mother-to-child transmissionBarmah Forest disease virus (BFDV)AustraliaMosquito (Culex spp)No dataNo dataNo dataChikungunya virus (CHIKV)America (tropical areas), Africa, Asia, Australia, Indian OceanMosquito (Aedes spp)No increased risk of severe maternal infectionTransmission documented, low incidence; miscarriages documented in three (2%) of 678 participants in one study and no increase in number of stillbirths, prematurity, or malformation8Gerardin P Barau G Michault A et al.Multidisciplinary prospective study of mother-to-child chikungunya virus infections on the island of La Reunion.PLoS Med. 2008; 5: e60Crossref PubMed Scopus (0) Google ScholarDocumented; transmission rate of 28–49%8Gerardin P Barau G Michault A et al.Multidisciplinary prospective study of mother-to-child chikungunya virus infections on the island of La Reunion.PLoS Med. 2008; 5: e60Crossref PubMed Scopus (0) Google Scholar, 12Torres JR Falleiros-Arlant LH Duenas L Pleitez-Navarrete J Salgado DM Castillo JB Congenital and perinatal complications of chikungunya fever: a Latin American experience.Int J Infect Dis. 2016; 51: 85-88Summary Full Text Full Text PDF PubMed Google Scholar with severe neonatal infection (encephalopathy) in 53% of newborns in one study;8Gerardin P Barau G Michault A et al.Multidisciplinary prospective study of mother-to-child chikungunya virus infections on the island of La Reunion.PLoS Med. 2008; 5: e60Crossref PubMed Scopus (0) Google Scholar severe neonatal infection with encephalopathy shown in four studies8Gerardin P Barau G Michault A et al.Multidisciplinary prospective study of mother-to-child chikungunya virus infections on the island of La Reunion.PLoS Med. 2008; 5: e60Crossref PubMed Scopus (0) Google Scholar, 13Nair PM Chikungunya in neonates.Indian Pediatr. 2008; 45: 605PubMed Google Scholar, 14Rao G Khan YZ Chitnis DS Chikungunya infection in neonates.Indian Pediatr. 2008; 45: 240-242PubMed Google Scholar, 15Shenoy S Pradeep GC Neurodevelopmental outcome of neonates with vertically transmitted Chikungunya fever with encephalopathy.Indian Pediatr. 2012; 49: 238-240PubMed Google ScholarEastern equine encephalitis virus (EEEV)America (North, Central, and South)Mosquito (Culiseta spp)No dataNo dataNo dataMayaro virus (MAYV)South AmericaMosquito (Aedes spp)No dataNo dataNo dataO'Nyong-nyong virus (ONNV)Central AfricaMosquito (Anopheles spp)No dataTransmission uncertain; two miscarriages reported, but link to infection unknown (fetuses untested)16Rwaguma EB Lutwama JJ Sempala SD et al.Emergence of epidemic o'nyong-nyong fever in southwestern Uganda, after an absence of 35 years.Emerg Infect Dis. 1997; 3: 77Crossref PubMed Google ScholarNo dataRoss River virus (RRV)Australia, Pacific areaMosquito (Aedes spp and Culex spp)No dataTransmission documented; 3% asymptomatic transmission in a case series17Aaskov JG Nair K Lawrence GW Dalglish DA Tucker M Evidence for transplacental transmission of Ross River virus in humans.Med J Aust. 1981; 2: 20-21PubMed Google ScholarNo dataSindbis virus (SINV)Africa, Asia, Australia, Europe (Norway, Sweden, and Finland)Mosquito (Aedes spp, Culex spp, and Culiseta spp)No dataTransmission uncertain; two stillbirths reported, including one following overt maternal infection at 32 weeks of gestation (fetuses untested)18Brummer-Korvenkontio M Vapalahti O Kuusisto P et al.Epidemiology of Sindbis virus infections in Finland 1981–96: possible factors explaining a peculiar disease pattern.Epidemiol Infect. 2002; 129: 335-345Crossref PubMed Scopus (0) Google ScholarNo dataVenezuelan equine encephalitis virus (VEEV)America (Central and South)Mosquito (Culex spp)No dataTransmission documented, incidence unknown; virus documented in the brains of ten aborted fetuses;19Weaver SC Salas R Rico-Hesse R et al.Re-emergence of epidemic Venezuelan equine encephalomyelitis in South America. VEE Study Group.Lancet. 1996; 348: 436-440Summary Full Text Full Text PDF PubMed Scopus (201) Google Scholar developmental brain lesions in infants born from mothers infected at 13–36 weeks of gestation20Wenger F Venezuelan equine encephalitis.Teratology. 1977; 16: 359-362Crossref PubMed Google ScholarNo dataWestern equine encephalitis virus (WEEV)America (North, Central, and South)Mosquito (Aedes spp and Culex spp)No dataNo dataDocumented, incidence unknown; three cases with severe encephalitis, one of which was fatal21Copps SC Giddings LE Transplacental transmission of western equine encephalitis; report of a case.Pediatrics. 1959; 24: 31-33PubMed Google Scholar, 22Shinefield HR Townsend TE Transplacental transmission of western equine encephalomyelitis.J Pediatr. 1953; 43: 21-25Summary Full Text PDF PubMed Google ScholarMiscarriages refer to fetal losses before 28 weeks of gestation. Stillbirths refer to fetal losses at 28 weeks of gestation or later. Open table in a new tab Table 2Classification, maternal risk, and consequences of mother-to-child transmission of major Flaviviridae virusesGeographical areaMain vectorsMaternal riskAntenatal consequences of mother-to-child transmissionPerinatal consequences of mother-to-child transmissionDengue virus (DENV)Tropical and subtropical areas worldwideMosquito (Aedes spp)Documented risk of severe infection; increased risk of haemorrhagic fever/shock syndrome compared with non-pregnant women of reproductive age (odds ratio 3·38, 95% CI 2·10–5·42)11Machado CR Machado ES Rohloff RD et al.Is pregnancy associated with severe dengue? A review of data from the Rio de Janeiro surveillance information system.PLoS Negl Trop Dis. 2013; 7: e2217Crossref PubMed Scopus (27) Google Scholar, 23Fritel X Rollot O Gerardin P et al.Chikungunya virus infection during pregnancy, Reunion, France, 2006.Emerg Infect Dis. 2010; 16: 418-425Crossref PubMed Google Scholar, 24Danis K Papa A Theocharopoulos G et al.Outbreak of West Nile virus infection in Greece, 2010.Emerg Infect Dis. 2011; 17: 1868-1872Crossref PubMed Scopus (115) Google Scholar, 25Jean CM Honarmand S Louie JK Glaser CA Risk factors for West Nile virus neuroinvasive disease, California, 2005.Emerg Infect Dis. 2007; 13: 1918-1920Crossref PubMed Google Scholar, 26Lindsey NP Staples JE Lehman JA Fischer M Medical risk factors for severe West Nile Virus disease, United States, 2008–2010.Am J Trop Med Hyg. 2012; 87: 179-184Crossref PubMed Scopus (0) Google ScholarTransmission documented; increased fetal losses in the first half of pregnancy (data from multiple cohorts, substantiated by a meta-analysis)27Carles G Peiffer H Talarmin A Effects of dengue fever during pregnancy in French Guiana.Clin Infect Dis. 1999; 28: 637-640Crossref PubMed Google Scholar, 28Tan PC Soe MZ Si Lay K Wang SM Sekaran SD Omar SZ Dengue infection and miscarriage: a prospective case control study.PLoS Negl Trop Dis. 2012; 6: e1637Crossref PubMed Scopus (18) Google Scholar, 29Paixão ES Teixeira MG Costa MD Rodrigues LC Dengue during pregnancy and adverse fetal outcomes: a systematic review and meta-analysis.Lancet Infect Dis. 2016; 16: 857-865Summary Full Text Full Text PDF PubMed Scopus (25) Google ScholarDocumented, incidence unknown; severe neonatal infection with sepsis-like symptoms and acute respiratory distress reported in case reports30Sirinavin S Nuntnarumit P Supapannachart S Boonkasidecha S Techasaensiri C Yoksarn S Vertical dengue infection: case reports and review.Pediatr Infect Dis J. 2004; 23: 1042-1047Crossref PubMed Scopus (0) Google Scholar, 31Basurko C Carles G Youssef M Guindi WE Maternal and fetal consequences of dengue fever during pregnancy.Eur J Obstet Gynecol Reprod Biol. 2009; 147: 29-32Summary Full Text Full Text PDF PubMed Scopus (68) Google ScholarJapanese encephalitis virus (JEV)Asia, AustraliaMosquito (Culex spp)No dataTransmission documented and severe; incidence unknown; fetal losses documented only in maternal infections occurring <22 weeks of gestation32Mathur A Tandon HO Mathur KR Sarkari NB Singh UK Chaturvedi UC Japanese encephalitis virus infection during pregnancy.Indian J Med Res. 1985; 81: 9-12PubMed Google ScholarNo dataKyasanur Forest disease virus (KFDV), Alkhurma haemorrhagic fever virus (AHFV)Asia (Middle East, India, southeast, and western Asia)Tick (Haemophysalis spp)No dataNo dataNo dataMurray Valley encephalitis virus (MVEV)Australia, Papua New GuineaMosquito (Culex spp)No dataNo dataNo dataPowassan virusNorth AmericaTick (Ixodes spp)No dataNo dataNo dataSaint Louis encephalitis virus (SLEV)America (North and Central)Mosquito (Culex spp)No dataNo dataNo dataTick-borne encephalitis virus (TBEV)Northern Europe and northern Asia (in a belt extending from eastern Europe to Japan)Tick (Ixodes spp)No dataNo dataNo dataWest Nile virus (WNV; also known as Kunjin virus in Oceania)Worldwide, most prevalent in America and Africa, low prevalence in EuropeMosquito (Culex spp)No dataTransmission documented; extremely rare; one case of congenital chorioretinitis and encephalitis after maternal infection at 27 weeks of gestation;33Centers for Disease Control and PreventionIntrauterine West Nile virus infection—New York, 2002.MMWR Morb Mortal Wkly Rep. 2002; 51: 1135-1136PubMed Google Scholar no significant increase in fetal losses or adverse long-term neurological outcome in US cohort studies34Sirois PA Pridjian G McRae S et al.Developmental outcomes in young children born to mothers with West Nile illness during pregnancy.Birth Defects Res A Clin Mol Teratol. 2014; 100: 792-796Crossref PubMed Scopus (4) Google Scholar, 35O'Leary DR Kuhn S Kniss KL et al.Birth outcomes following West Nile Virus infection of pregnant women in the United States: 2003–2004.Pediatrics. 2006; 117: e537-e545Crossref PubMed Scopus (119) Google Scholar, 36Pridjian G Sirois PA McRae S et al.Prospective study of pregnancy and newborn outcomes in mothers with West Nile illness during pregnancy.Birth Defects Res A Clin Mol Teratol. 2016; 106: 716-723Crossref PubMed Scopus (0) Google ScholarUncertain; two cases with encephalitis that developed 6–10 days after birth (maternal symptoms 21–6 days before delivery, no documentation of viral infection at birth);35O'Leary DR Kuhn S Kniss KL et al.Birth outcomes following West Nile Virus infection of pregnant women in the United States: 2003–2004.Pediatrics. 2006; 117: e537-e545Crossref PubMed Scopus (119) Google Scholar one case with transient rash at birth and positive IgM 1 month later (maternal symptoms at birth)35O'Leary DR Kuhn S Kniss KL et al.Birth outcomes following West Nile Virus infection of pregnant women in the United States: 2003–2004.Pediatrics. 2006; 117: e537-e545Crossref PubMed Scopus (119) Google ScholarYellow fever virus (YFV)Sub-Saharan Africa, South AmericaMosquito (Aedes spp or Haemagogus spp)No dataTransmission documented; extremely rare; two cases of fatal and maternal infection at 4–5 months of pregnancy with lesions compatible with yellow fever virus in the fetuses37Sicé A Rodallec B Manifestations hémorragiques de la fièvre jaune.Bull Soc Pathol Exot. 1940; 33: 79-83Google ScholarDocumented, probably extremely rare; one report of fatal neonatal infection (maternal symptoms onset 3 days before delivery)38Bentlin MR de Barros Almeida RA Coelho KI et al.Perinatal transmission of yellow fever, Brazil, 2009.Emerg Infect Dis. 2011; 17: 1779-1780Crossref PubMed Scopus (0) Google ScholarZika virus (ZIKV)South Pacific area, Latin America, Caribbean, USA (Florida and Puerto Rico)Mosquito (Aedes spp)··Transmission documented; incidence of 1–13% brain abnormalities at birth;39Cauchemez S Besnard M Bompard P et al.Association between Zika virus and microcephaly in French Polynesia, 2013–15: a retrospective study.Lancet. 2016; 387: 2125-2132Summary Full Text Full Text PDF PubMed Scopus (418) Google Scholar, 40Johansson MA Mier-y-Teran-Romero L Reefhuis J Gilboa SM Hills SL Zika and the risk of microcephaly.N Engl J Med. 2016; 375: 1-4Crossref PubMed Scopus (220) Google Scholar teratogenic according to multiple case reports and case series;41Coyne CB Lazear HM Zika virus—reigniting the TORCH.Nat Rev Microbiol. 2016; 14: 707-715Crossref PubMed Scopus (79) Google Scholar severe microcephaly and other brain lesions;39Cauchemez S Besnard M Bompard P et al.Association between Zika virus and microcephaly in French Polynesia, 2013–15: a retrospective study.Lancet. 2016; 387: 2125-2132Summary Full Text Full Text PDF PubMed Scopus (418) Google Scholar, 42Brasil P Pereira Jr, JP Raja Gabaglia C et al.Zika virus infection in pregnant women in Rio de Janeiro—preliminary report.N Engl J Med. 2016; 375: 2321-2334Crossref PubMed Scopus (0) Google Scholar, 43Honein MA Dawson AL Petersen EE et al.Birth defects among fetuses and infants of us women with evidence of possible Zika virus infection during pregnancy.JAMA. 2017; 317: 59-68Crossref PubMed Scopus (169) Google Scholar retinal lesions;44Ventura CV Maia M Ventura BV et al.Ophthalmological findings in infants with microcephaly and presumable intra-uterus Zika virus infection.Arq Bras Oftalmol. 2016; 79: 1-3Crossref PubMed Google Scholar prematurity or fetal losses;45Franca GV Schuler-Faccini L Oliveira WK et al.Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation.Lancet. 2016; 388: 891-897Summary Full Text Full Text PDF PubMed Scopus (205) Google Scholar organogenesis and weight usually preserved;45Franca GV Schuler-Faccini L Oliveira WK et al.Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation.Lancet. 2016; 388: 891-897Summary Full Text Full Text PDF PubMed Scopus (205) Google Scholar and impaired postnatal neurological development with poor cranial growth, irritability, pyramidal or extrapyramidal symptoms, and epilepsy46Moura da Silva AA Ganz JS Sousa PD et al.Early growth and neurologic outcomes of infants with probable congenital Zika virus syndrome.Emerg Infect Dis. 2016; 22: 1953-1956Crossref PubMed Scopus (54) Google ScholarDocumented; probably extremely rare; two French Polynesian case reports of possible perinatal transmission (one asymptomatic, one with mild rash)47Besnard M Lastere S Teissier A Cao-Lormeau V Musso D Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014.Euro Surveill. 2014; 19: 1-4Crossref Google ScholarMiscarriages refer to fetal losses before 28 weeks of gestation. Stillbirths refer to fetal losses at 28 weeks of gestation or later. Open table in a new tab Table 3Classification, maternal risk, and consequences of mother-to-child transmission of major Bunyaviridae, Reoviridae, and Rhabdoviridae arbovirusesGeographical areaMain vectorsMaternal riskAntenatal consequences of mother-to-child transmissionPerinatal consequences of mother-to-child transmissionCrimean-Congo haemorrhagic fever virus (CCHFV)Europe (southeast and eastern), Africa, Middle East, countries south of the 50th parallelMidge (Culicoides spp); tick (>30 species involved)Documented increased risk of severe infection: increased mortality (34%48Pshenichnaya NY Leblebicioglu H Bozkurt I et al.Crimean–Congo hemorrhagic fever in pregnancy: a systematic review and case series from Russia, Kazakhstan and Turkey.Int J Infect Dis. 2017; 58: 58-64Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar)Transmission documented, incidence unknown; four miscarriages at 4–19 weeks of gestation (fetuses untested);48Pshenichnaya NY Leblebicioglu H Bozkurt I et al.Crimean–Congo hemorrhagic fever in pregnancy: a systematic review and case series from Russia, Kazakhstan and Turkey.Int J Infect Dis. 2017; 58: 58-64Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar stillbirths with maternal death48Pshenichnaya NY Leblebicioglu H Bozkurt I et al.Crimean–Congo hemorrhagic fever in pregnancy: a systematic review and case series from Russia, Kazakhstan and Turkey.Int J Infect Dis. 2017; 58: 58-64Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar, 49Gozel MG Elaldi N Engin A Akkar OB Bolat F Celik C Favorable outcomes for both mother and baby are possible in pregnant women with Crimean–Congo hemorrhagic fever disease: a case series and literature review.Gynecol Obstet Invest. 2014; 77: 266-271Crossref PubMed Google ScholarDocumented, incidence unknown; one case of documented fatal neonatal infection50Ergonul O Celikbas A Yildirim U et al.Pregnancy and Crimean–Congo haemorrhagic fever.Clin Microbiol Infect. 2010; 16: 647-650Summary Full Text Full Text PDF PubMed Scopus (0) Google ScholarLa Crosse virus (LACV)North America (mid-western and eastern)Mosquito (Aedes spp)No dataTransmission documented, incidence unknown; one asymptomatic mother-to-child transmission documented serologically in cord serum, after a maternal infection at 21 weeks of gestation51Possible congenital infection with La Crosse encephalitis virus—West Virginia, 2006–2007.MMWR Morb Mortal Wkly Rep. 2009; 58: 4-7PubMed Google ScholarNo dataOropouche virus (OROV)America (Central and South)Midge (Culicoides spp)No dataNo dataNo dataRift Valley fever virus (RVFV)Africa, Middle East, AsiaMosquito (Aedes spp, Culex spp, and Anopheles spp)No dataTransmission documented; increased risk of miscarriage in a cross-sectional study comparing miscarriages in pregnant patients with documented Rift Valley fever virus (15 [54%] of 28 participants) vs pregnant women with documented chikungunya virus infection (12 [12%] of 103)52Baudin M Jumaa AM Jomma HJ et al.Association of Rift Valley fever virus infection with miscarriage in Sudanese women: a cross-sectional study.Lancet Glob Health. 2016; 4: e864-e871Summary Full Text Full Text PDF PubMed Scopus (22) Google ScholarDocumented, incidence unknown; two symptomatic cases (infants born to mothers who were symptomatic 4–6 days before delivery; symptoms were present at birth or 4 days after delivery [one with rash and organomegaly, and one with disseminated fatal infection])53Adam I Karsany MS Case report: Rift Valley fever with vertical transmission in a pregnant Sudanese woman.J Med Virol. 2008; 80: 929Crossref PubMed Scopus (26) Google Scholar, 54Arishi HM Aqeel AY Al Hazmi MM Vertical transmission of fatal Rift Valley fever in a newborn.Ann Trop Paediatr. 2006; 26: 251-253Crossref PubMed Scopus (30) Google ScholarSevere fever with thrombocytopenia syndrome virus (SFTSV)Asia (eastern China, Japan, and Korea)Not completely elucidated; evidenced in ticks (Haemaphysalis spp)No dataNo dataNo dataTahyna virus (TAHV)Europe, Africa, AsiaMosquito (Culex spp)No dataNo dataNo dataToscana virus (TOSCV)EuropeSandfly (Phlebotomus spp)No dataNo dataNo dataColorado tick fever virus (CTFV)North AmericaTick (Dermacentor spp)No dataTransmission uncertain; two miscarriages after maternal infections (fetuses not tested)55Eklund CM Kohls GM Jellison WL The clinical and ecological aspects of Colorado tick fever. (Proceedings of the 6th International Congress Tropical Medicine Malaria, Lisbon).An Inst Med Trop (Lisbon). 1959; 5: 197-203Google ScholarUncertain; one possible case (fever and leucopenia in a neonate delivered 6 days after maternal infection onset)55Eklund CM Kohls GM Jellison WL The clinical and ecological aspects of Colorado tick fever. (Proceedings of the 6th International Congress Tropical Medicine Malaria, Lisbon).An Inst Med Trop (Lisbon). 1959; 5: 197-203Google ScholarChandipura virus (CHPV)AsiaSandfly (Sergentomyia spp)No dataNo dataNo dataMiscarriages refer to fetal losses before 28 weeks of gestation. Stillbirths refer to fetal losses at 28 weeks of gestation or later. Open table in a new tab Miscarriages refer to fetal losses before 28 weeks of gestation. Stillbirths refer to fetal losses at 28 weeks of gestation or later. Miscarriages refer to fetal losses before 28 weeks of gestation. Stillbirths refer to fetal losses at 28 weeks of gestation or later. Miscarriages refer to fetal losses before 28 weeks of gestation. Stillbirths refer to fetal losses at 28 weeks of gestation or later. Key messages•Arboviruses are an expanding public health threat; some arbovirus infections, such as dengue and Crimean–Congo haemorrhagic fever, are more severe in pregnant women than in the general population•Flaviviruses, especially dengue virus and Japanese encephalitis virus, are associated with increased risk of fetal loss (miscarriages and stillbirths)•Zika virus and Venezuelan equine encephalitis virus are teratogenic, causing fetal complications such as microcephaly for Zika virus•Intrapartum arbovirus mother-to-child transmission, especially of chikungunya virus, might cause severe neonatal disease, such as encephalitis•The actual burden of arbovirus infections during pregnancy and the true incidence of adverse fetal outcomes remain unknown •Arboviruses are an expanding public health threat; some arbovirus infections, such as dengue and Crimean–Congo haemorrhagic fever, are more severe in pregnant women than in the general population•Flaviviruses, especially dengue virus and Japanese encephalitis virus, are associated with increased risk of fetal loss (miscarriages and stillbirths)•Zika virus and Venezuelan equine encephalitis virus are teratogenic, causing fetal complications such as microcephaly for Zika virus•Intrapartum arbovirus mother-to-child transmission, especially of chikungunya virus, might cause severe neonatal disease, such as encephalitis•The actual burden of arbovirus infections during pregnancy and the true inc" @default.
• W2743104675 created "2017-08-17" @default.
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• W2743104675 date "2017-10-01" @default.
• W2743104675 modified "2023-10-14" @default.
• W2743104675 title "Arboviruses and pregnancy: maternal, fetal, and neonatal effects" @default.
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