Shigellosis and Pregnancy in French Guiana: Obstetric and Neonatal Complications

Am J Trop Med Hyg. 2016 Jul 6;95(1):26-30. doi: 10.4269/ajtmh.15-0669. Epub 2016 Apr 25.

Abstract

Shigella is a major cause of dysentery worldwide. Only a few cases of shigellosis during pregnancy have been reported. However, the neonatal and obstetric complications are potentially severe. The objective of this study was to describe the obstetric and neonatal complications of shigellosis during pregnancy. We carried out a retrospective study of 37 cases of shigellosis diagnosed in pregnant women at the maternity unit of Saint-Laurent du Maroni Hospital in west French Guiana between 2000 and 2014. Shigellosis diagnosis was based on the detection of Shigella in stool cultures from pregnant women (34 patients) or in a neonatal sample collected immediately after delivery (three neonates). In addition to the classic symptoms of shigellosis-an association of diarrhea, fever, and abdominal pain-we observed uterine contractions before the completion of 37 weeks of gestation in 61% of patients (N = 17/28). Cervical changes were associated with uterine contractions in 82% of cases (N = 14/17); 25% of the patients at risk of preterm birth went on to give birth prematurely (N = 3/12). Three cases of mother-to-child transmission were observed. Episodes of shigellosis in pregnant women may trigger uterine contractions and changes to the cervix, potentially resulting in miscarriage or preterm birth.

MeSH terms

  • Abortion, Spontaneous / microbiology
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Cervix Uteri / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Dysentery, Bacillary / drug therapy
  • Dysentery, Bacillary / transmission*
  • Feces / microbiology
  • Female
  • French Guiana
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / drug therapy
  • Infant, Newborn, Diseases / microbiology*
  • Infectious Disease Transmission, Vertical
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / microbiology*
  • Pregnancy Outcome
  • Premature Birth / microbiology
  • Retrospective Studies
  • Risk Factors
  • Shigella / drug effects
  • Shigella / isolation & purification
  • Young Adult

Substances

  • Anti-Bacterial Agents