Neonatal outcomes of pregnant women seropositive for rubella antibodies attending a tertiary hospital antenatal clinic in Kano, Nigeria

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Abstract

Background Maternal rubella infection during pregnancy, especially in the first trimester, poses a significant risk to the developing fetus because the virus can cross the placenta, causing damage to various organs, leading to congenital rubella syndrome. This study aimed to assess neonatal outcomes and the burden of rubella infection among neonates of mothers seropositive for rubella antibodies at Aminu Kano Teaching Hospital, Kano (AKTH). Methods This cross-sectional study was conducted among 163 pregnant women and their neonates attending the antenatal clinic (ANC) at AKTH. Blood samples were collected from consenting pregnant women, and cord blood samples were collected from their neonates at delivery. All maternal samples were subjected to antibody testing (IgG and IgM). The neonates were examined at birth, and their cord blood samples of seropositive mothers were checked for hematocrit, platelet count and subjected to antibody testing (IgM). Results The mean age of the participants was 27.6 ± 5.7 years. The overall prevalence of IgM-seropositive neonates, irrespective of maternal antibody status, was 52.1%. Among neonates of IgG-seropositive mothers, 4.9% had both microcephaly and a cardiac defect, while microcephaly alone was reported in 1.1% of neonates of IgM-seropositive mothers. Skin lesions were observed in 1.6% and 1.1% of neonates of IgG- and IgM-seropositive mothers, respectively. Anaemia was documented in 1.1% and 3.3% of neonates of IgG- and IgM-seropositive mothers, respectively, whereas thrombocytopenia was found in 10.5% and 14.8% of neonates, respectively. There was no significant difference in neonatal outcomes between neonates of rubella-seropositive and seronegative mothers. Conclusion The study found a high prevalence of rubella IgM among neonates born to seropositive mothers, highlighting the need for policy changes to introduce the rubella vaccine to curb rubella transmission and prevent congenital rubella syndrome.

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