Seroprevalence and pregnancy outcome in Rubella infection in antenatal women with bad obstetric history: A case control study

Authors : Divya Pandey, Divya Pandey, Monika Gupta, Monika Gupta

DOI : 10.18231/2394-2754.2019.0006

Volume : 6

Issue : 1

Year : 2019

Page No : 24-28

Objective: To evaluate seroprevalence of Rubella infection in antenatal patients with bad obstetric history (BOH), pregnancy outcome of seropositive cases and incidence of congenital malformations in maternal Rubella infection.
Materials and Methods: This was a prospective case control study done at a tertiary teaching institute over duration of one year. One hundred and seventy four antenatal women with BOH were studied against one hundred and six control cases. Their serum sample was subjected to ELISA test for Rubella IgG and IgM antibodies estimation at their first antenatal visit. Interconception interval i.e. the time interval between the previous pregnancy loss and current pregnancy was noted. All women were followed to know the pregnancy outcome. Apparent congenital anomalies in the newborns were evaluated. Chi square test was applied for statistical analysis.
Result: Seropositivity for Rubella IgG antibodies, IgM antibodies and both IgG and IgM was 48.3%, 25% and 3.5% respectively in study group. Abortions, preterm delivery and stillbirths were seen in 56.8%, 18.3% and 4.5% of IgM positive cases. 2.24% with IgG positive had abortion while 4.5% with both IgG and IgM antibodies had fetal congenital malformation. Incidence of congenital anomalies in the form of Neural Tube Defects was 4.48%. Abnormal pregnancy outcome in present pregnancy was seen in 59.1% of women with interconception interval less than 3 months.
Conclusions: Seropositivity of IgM Rubella antibodies was significantly higher in women with Bad Obstetric History. Incidence of Neural Tube Defects was higher with Rubella infection if exposure occurs in first few weeks of pregnancy. There is need for immunization against Rubella, of adolescent girls and seronegative prospective mothers. A proper (more than 3 months) interconception interval should be recommended after acute Rubella infection in pregnancy causing obstetric loss in that pregnancy.

Keywords: German measles, Rubella in pregnancy, Pregnancy loss, Interconception interval.

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