Chikungunya durante a gestação e nascimento: um estudo coorte retrospectivo da maior epidemia do Brasil

Abstract

Introduction. Chikungunya (CHIK) is a vector-borne viral disease that can affect pregnant women living in or traveling to epidemic areas. However, the effects of the infection during pregnancy on birth outcomes remain poorly understood. Objectives. Describe the epidemiologic profile of women confirmed with chikungunya during pregnancy and estimate the risk of prematurity, low weight at birth and congenital malformations in a retrospective live births cohort. Methods. It is a descriptive study of the confirmed cases of infected pregnant women in Brazil, with beginning of symptoms between January of 2016 and December of 2018. The study uses data from the National Reportable Disease Information System (SINAN), followed by a retrospective cohort using secondary data based on a probabilistic linkage between databases from: SINAN, Live Birth Information System (SINASC) from January of 2016 to September 2019. Results. Between 2016 and 2018 were confirmed 3332 cases of women infected with chikungunya during pregnancy, which originated 3262 newborns, 4 maternal deaths, 35 fetal deaths, 31 neonatal deaths, manly in the northeast region (65,15) and the state of Ceará (28,3%). The maternal infection had a protective relationship with low birth weight (RR = 0.65, CI95% = 0.56-0.76, p <0.001) and prematurity (RR = 0.72, CI95% = 0.63-0.82, p<0.001) and no significant relationship was found with congenic malformations (IC95% = 0.83-1.97, p=0.262). Conclusions. CHIK during pregnancy did not increase the risks of low birth weight or premature birth, instead a protective relation was found and no significant statistic relation was found for congenital malformations. Thus, our results should not be utilized to conclude that maternal CHIKV infection during pregnancy is a protective factor for neonates.