Advertisement

Increased risk of adverse pregnancy outcomes among women affected by herpangina

Published:April 26, 2010DOI:https://doi.org/10.1016/j.ajog.2010.02.025

      Objective

      This population-based study aimed to assess the relation between herpangina and adverse pregnancy outcomes: low birthweight (LBW), small for gestational age (SGA), and preterm delivery.

      Study Design

      A total of 242 pregnant women who had singleton births and who visited ambulatory care centers for the treatment of herpangina were assessed, together with 1936 matched women as a comparison group. Conditional logistic regression analyses were performed to examine the risk of LBW, preterm birth, and SGA for mothers with herpangina and unaffected mothers.

      Results

      Compared with pregnant women without herpangina, herpangina was associated with a 2.29- (95% confidence interval [CI], 1.42–3.69), 1.67- (95% CI, 1.04–2.68), and 1.63-fold (95% CI, 1.14–2.33) increased risk of having LBW, preterm, and SGA infants, respectively, after adjusting for family income and maternal and infant characteristics.

      Conclusion

      Our findings highlight a significant potential risk posed by herpangina, a usually mild disease, among pregnant women.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Chen K.T.
        • Chang H.L.
        • Wang S.T.
        • Cheng Y.T.
        • Yang J.Y.
        Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan, 1998-2005.
        Pediatrics. 2007; 120: e244-e252
        • Sano T.
        • Saito T.
        • Kondo M.
        • et al.
        Enterovirus detection status of patients with herpangina and hand, foot and mouth disease in epidemic season 2007, Kanagawa Prefecture, Japan.
        Jpn J Infect Dis. 2008; 61: 162-163
        • Ishimaru Y.
        • Nakano S.
        • Yamaoka K.
        • Takami S.
        Outbreaks of hand, foot, and mouth disease by enterovirus 71.
        Arch Dis Child. 1980; 55: 583-588
        • Wang S.M.
        • Liu C.C.
        • Tseng H.W.
        • et al.
        Clinical spectrum of enterovirus 71 infection in children in southern Taiwan, with an emphasis on neurological complications.
        Clin Infect Dis. 1999; 29: 184-190
        • Chang L.Y.
        • King C.C.
        • Hsu K.H.
        • et al.
        Risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease/herpangina in children during an epidemic in Taiwan.
        Pediatrics. 2002; 109: e88
        • Shah V.A.
        • Chong C.Y.
        • Chan K.P.
        • Ng W.
        • Ling A.E.
        Clinical characteristics of an outbreak of hand, foot and mouth disease in Singapore.
        Ann Acad Med Singapore. 2003; 32: 381-387
        • Chan K.P.
        • Goh K.T.
        • Chong C.Y.
        • Teo E.S.
        • Lau G.
        • Ling A.E.
        Epidemic hand, foot and mouth disease caused by human enterovirus 71, Singapore.
        Emerg Infect Dis. 2003; 9: 78-85
        • Chan L.G.
        • Parashar U.D.
        • Lye M.S.
        • et al.
        Deaths of children during an outbreak of hand, foot, and mouth disease in Sarawak, Malaysia: clinical and pathological characteristics of the disease.
        Clin Infect Dis. 2000; 31: 678-683
        • Chow K.C.
        • Lee C.C.
        • Lin T.Y.
        • et al.
        Congenital enterovirus 71 infection: a case study with virology and immunohistochemistry.
        Clin Infect Dis. 2000; 31: 509-512
        • Nuovo G.J.
        • Cooper L.D.
        • Bartholomew D.
        Histologic, infectious, and molecular correlates of idiopathic spontaneous abortion and perinatal mortality.
        Diagn Mol Pathol. 2005; 14: 152-158
        • Elfving M.
        • Svensson J.
        • Oikarinen S.
        • et al.
        Maternal enterovirus infection during pregnancy as a risk factor in offspring diagnosed with type 1 diabetes between 15 and 30 years of age.
        Exp Diabetes Res. 2008; 2008 (271958)
        • Svensson J.
        • Lindberg B.
        • Jonsson B.
        • et al.
        Intrauterine exposure to maternal enterovirus infection as a risk factor for development of autoimmune thyroiditis during childhood and adolescence.
        Thyroid. 2004; 14: 367-370
        • Lin C.M.
        • Lee P.C.
        • Teng S.W.
        • Lu T.H.
        • Mao I.F.
        • Li C.Y.
        Validation of the Taiwan Birth Registry using obstetric records.
        J Formos Med Assoc. 2004; 103: 297-301
        • Rothman K.J.
        Modern epidemiology.
        Little, Brown and Company, Boston, MA1986
        • Hennessy S.
        • Bilker W.B.
        • Berlin J.A.
        • Strom B.L.
        Factors influencing the optimal control-to-case ratio in matched case-control studies.
        Am J Epidemiol. 1999; 149: 195-197
        • Cleary-Goldman J.
        • Malone F.D.
        • Vidaver J.
        • et al.
        Impact of maternal age on obstetric outcome.
        Obstet Gynecol. 2005; 105: 983-990
        • Chen Y.H.
        • Lin H.L.
        • Lin H.C.
        Does multiple sclerosis increase risk of adverse pregnancy outcomes?.
        Mult Scler. 2009; 15: 606-612
        • Lin H.C.
        • Tang C.H.
        • Lee H.C.
        Association between paternal schizophrenia and low birthweight: a nationwide population-based study.
        Schizophr Bull. 2009; 35: 624-630
        • Kirchengast S.
        • Mayer M.
        • Voigt M.
        Pregnancy outcome is associated with maternal marital status in Austria—even at the beginning of the 21st century.
        Anthropol Anz. 2007; 65: 415-426
        • Ingemarsson I.
        Gender aspects of preterm birth.
        BJOG. 2003; 110: 34-38
        • Di Renzo G.C.
        • Rosati A.
        • Sarti R.D.
        • Cruciani L.
        • Cutuli A.M.
        Does fetal sex affect pregnancy outcome?.
        Gend Med. 2007; 4: 19-30
        • Bruce F.C.
        • Berg C.J.
        • Hornbrook M.C.
        • et al.
        Maternal morbidity rates in a managed care population.
        Obstet Gynecol. 2008; 111: 1089-1095
        • Peticca P.
        • Keely E.J.
        • Walker M.C.
        • Yang Q.
        • Bottomley J.
        Pregnancy outcomes in diabetes subtypes: how do they compare?.
        J Obstet Gynaecol Can. 2009; 31: 487-496
        • Xiong X.
        • Buekens P.
        • Alexander S.
        • Demianczuk N.
        • Wollast E.
        Anemia during pregnancy and birth outcome: a meta-analysis.
        Am J Perinatol. 2000; 17: 137-146
        • King J.C.
        Maternal obesity, metabolism, and pregnancy outcomes.
        Annu Rev Nutr. 2006; 26: 271-291
        • Thanajiraprapa T.
        • Phupong V.
        Pregnancy complications in women with heart disease.
        J Matern Fetal Neonatal Med. 2009; ([Epub ahead of print])
        • Chong C.Y.
        • Chan K.P.
        • Shah V.A.
        • et al.
        Hand, foot and mouth disease in Singapore: a comparison of fatal and non-fatal cases.
        Acta Paediatr. 2003; 92: 1163-1169
        • Miyazawa I.
        • Azegami Y.
        • Kasuo S.
        • Yoshida T.
        • Kobayashi M.
        • Shiraishi T.
        Prevalence of enterovirus from patients with herpangina and hand, foot and mouth disease in Nagano Prefecture, Japan, 2007.
        Jpn J Infect Dis. 2008; 61: 247-248
        • Murakami Y.
        • Hashimoto S.
        • Ohta A.
        • et al.
        Wide-area epidemics of influenza and pediatric diseases from infectious disease surveillance in Japan, 1999-2005.
        J Epidemiol. 2007; 17: S23-S31
        • Saoji V.A.
        Hand, foot and mouth disease in Nagpur.
        Indian J Dermatol Venereol Leprol. 2008; 74: 133-135
        • Ogilvie M.M.
        • Tearne C.F.
        Spontaneous abortion after hand-foot-and-mouth disease caused by Coxsackie virus A16.
        Br Med J. 1980; 281: 1527-1528
        • Palmer A.L.
        • Rotbart H.A.
        • Tyson R.W.
        • Abzug M.J.
        Adverse effects of maternal enterovirus infection on the fetus and placenta.
        J Infect Dis. 1997; 176: 1437-1444
        • Savitz D.A.
        • Ananth C.V.
        • Berkowitz G.S.
        • Lapinski R.
        Concordance among measures of pregnancy outcome based on fetal size and duration of gestation.
        Am J Epidemiol. 2000; 151: 627-633