Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 12, Number 7—July 2006
Dispatch

Smallpox during Pregnancy and Maternal Outcomes

Hiroshi Nishiura*†Comments to Author 
Author affiliation: *University of Tübingen, Tübingen, Germany; †Hiroshima University, Hiroshima, Japan

Main Article

Table A2

Miscarriage or premature birth among pregnant women with smallpox by clinical types of variola major, according to data from 19th- and early 20th-century outbreaks

Reference Hemorrhagic
 Confluent
 Discrete
 VSE
L/C PL (95% CI) L/C PL (95% CI) L/C PL (95% CI) L/C PL (95% CI)
Meyer (1), 1868–1872 13/13 100.0 (NC) 14/26 53.8 (34.7–73.0) – – 4/37 10.8 (0.8–20.8)
Sangregorio (2), 1887 3/3 100.0 (NC) 17/22 77.3 (59.8–94.8) 10/40 25.0 (11.6–38.4) 1/7 14.3 (0.0–40.2)
Charpentier (4), 1898 13/13 100.0 (NC) 18/34 52.9 (36.2–69.7) 9/45 20.0 (8.3–31.7) – –
Queirel (5), 1906 8/8 100.0 (NC) 3/3 100.0 (NC) 0/8 0.0 (NC) – –

*Hemorrhagic, widespread hemorrhages in the skin and mucous membranes; confluent, confluent rash on the face and arms; discrete, areas of normal skin visible between pustules, even on the face; VSE, variola sine eruptione, fever without rash caused by variola virus, also known as varioloid (8,9); L/C, miscarriage or premature birth/cases; PL, proportion of miscarriage or premature birth; CI, confidence interval; NC, not calculable.

Main Article

References
  1. Henderson  DA, Inglesby  TV, Bartlett  JG, Ascher  MS, Eitzen  E, Jahrling  PB, Smallpox as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA. 1999;281:2127–37. DOIPubMedGoogle Scholar
  2. Suarez  VR, Hankins  GD. Smallpox and pregnancy: from eradicated disease to bioterrorist threat. Obstet Gynecol. 2002;100:87–93. DOIPubMedGoogle Scholar
  3. Fenner  F, Henderson  DA, Arita  I, Ježek  Z, Ladnyi  ID. Smallpox and its eradication. Geneva: World Health Organization; 1988 [cited 2006 May 4]. Available from http://whqlibdoc.who.int/smallpox/9241561106.pdf
  4. Rao  AR, Prahlad  I, Swaminathan  M, Lakshmi  A. Pregnancy and smallpox. J Indian Med Assoc. 1963;40:353–63.PubMedGoogle Scholar
  5. Rao  AR. Haemorrhagic smallpox: a study of 240 cases. J Indian Med Assoc. 1964;43:224–9.PubMedGoogle Scholar
  6. Dixon  CW. Smallpox in Tripolitania, 1946: an epidemiological and clinical study of 500 cases, including trials of penicillin treatment. J Hyg (Lond). 1948;46:351–77. DOIPubMedGoogle Scholar
  7. Voigt  L. Über den Einfluss der Pockenkrankheit auf Menstruation, Schwangerschaft, Geburt und Fötus. Sammlung Klinischer Vortraege/Gynaekologie. 1894–1897;112:249–72
  8. Scheby-Buch . Bericht über das Material des Hamburger Pockenhauses vom August 1871 bis Februar 1872. Arch Derm Syphilol. 1872–1873;4:506–32. DOIGoogle Scholar
  9. Meyer  L. Über Pocken beim weiblichen Geschlecht. Beiträge zur Geburtshülfe und Gynäkologie / hrsg. von d. Gesellschaft für Geburtshülfe in Berlin (Berlin: Crede). 1873;2:186–98.
  10. Welch  WM. Smallpox in the pregnant woman and in the foetus. Philadelphia Medical Times. 1877–1878;8:390–8.
  11. Jobard. Influence de la variole sur la grossesse [thesis]. Paris: Université de Paris; 1880.
  12. Barthélemy. Recherches sur l'influence de lavariole sur la grossesse [thesis]. Paris: Université de Paris; 1880.
  13. Sangregorio  G. Vaiuolo e gravidanza. Cenni statistici (1). Guardia Ostetrica di Milano. I Morgagni. 1887;29:793–6.
  14. Richardière. La variole pendant la grossesse. Arch de Tocol et de Gynecol. 1893;20:611–5.
  15. van der Willigen  AM. Pokken in de Zwangerschap, 80 gevallen van variolae gravidarum. Ned Tijdschr Geneeskd. 1895;11:485–99.
  16. Charpentier  JB. Variole et vaccine dans la grossesse [thesis]. Paris: Université de Paris; 1900.
  17. Viany  C. Vaccine et variole au cours de la grossesse [thesis]. Lyon Med. 1900;93:397–401.
  18. Queirel . Variole et grossesse. Annales de Gynecologie et d'Obstetrique. 1907;4:137–47.
  19. Robertson  DG. Small-pox epidemic in New South Wales, 1913. Melbourne, Australia: Minister for Trade and Customs; 1914.
  20. Couréménos  M. Influence de la variole sur la grossesse et le produit de la conception [thesis]. Paris: Université de Paris; 1901.
  21. Crapo  RO. Normal cardiopulmonary physiology during pregnancy. Clin Obstet Gynecol. 1996;39:3–16. DOIPubMedGoogle Scholar
  22. Hassett  DE. Smallpox infections during pregnancy, lessons on pathogenesis from nonpregnant animal models of infection. J Reprod Immunol. 2003;60:13–24. DOIPubMedGoogle Scholar

Main Article

Page created: December 16, 2011
Page updated: December 16, 2011
Page reviewed: December 16, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external