Chikungunya Infection in Pregnancy: Reassuring Maternal and Perinatal Outcomes

Objective: To evaluate disease severity, pregnancy outcomes, and mother-to-child transmission of women with acute Chikungunya infection (CHIKV) during pregnancy.
Methods: This retrospective cohort study investigated 731 mother-infant pairs who gave birth in Grenada from January 2014 to September 2015 during a large CHIKV outbreak. Women and their infants underwent serologic testing for CHIKV by enzyme-linked immunosorbent assay. Data on maternal symptoms, pregnancy outcomes, and neonatal outcomes were collected and analyzed.
Results: Of 416 mother-infant pairs deemed eligible for inclusion, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never been infected with CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Symptomatic neonatal disease from mother-to-child transmission occurred in two (1.3%) mother-infant pairs. Mean duration of joint pain was shorter among women infected during pregnancy compared to women infected outside of pregnancy (P<0.0001). Pregnancy and neonatal outcomes were otherwise similar between the groups.
Conclusion: CHIKV infection during pregnancy did not pose an increased risk for adverse outcomes unless infection occurred just prior to delivery. If infection occurs during pregnancy, it may be protective against long-term joint pain sequelae that is often associated with acute CHIKV infection.
Funding source: National Institute of Health Fogarty International Center, grant # 1R21TW010536-01