Routine screening for Coxiella burnetii infection during pregnancy: a clustered randomised controlled trial during an outbreak, the Netherlands, 2010.

Munster, J M; Leenders, A C; Hamilton, C J; Meekelenkamp, J C; Schneeberger, P M; van der Hoek, W; Rietveld, A; de Vries, E; Stolk, R P; Aarnoudse, J G; Hak, E

Munster, J M; Leenders, A C; Hamilton, C J; Meekelenkamp, J C; Schneeberger, P M; van der Hoek, W; Rietveld, A; de Vries, E; Stolk, R P; Aarnoudse, J G; Hak, E.

Afiliación

Munster JM; University of Groningen, University Center for Pharmacy, PharmacoEpidemiology & PharmacoEconomics, Groningen, the Netherlands. j.munster@umcg.nl

Euro Surveill ; 18(24)2013 Jun 13.

Article en En | MEDLINE | ID: mdl-23787163

RESUMEN

Between 2007 and 2010, the Netherlands experienced one of the largest outbreaks of Q fever. Since asymptomatic Coxiella burnetii infection has been associated with maternal and obstetric complications, evidence about the effectiveness of routine screening during pregnancy in outbreak areas is needed. We performed a clustered randomised controlled trial during the Dutch outbreak, in which 55 midwife centres were randomised to recruit pregnant women for an intervention or control strategy. In both groups a serum sample was taken between 20 and 32 weeks of gestation. In the intervention group (n=536), the samples were analysed immediately by indirect immunofluorescence assay for the presence of IgM and IgG (phase I/II) and treatment was given during pregnancy in case of an acute or chronic infection. In the control group (n=693), sera were frozen for analysis after delivery. In both groups 15% were seropositive. In the intervention group 2.2% of the women were seropositive and had an obstetric complication, compared with 1.4% in the control group (Odds ratio: 1.54 (95% confidence interval 0.60-3.96)). During a large Q fever outbreak, routine C. burnetii screening starting at 20 weeks of gestation was not associated with a relevant reduction in obstetric complications and should therefore not be recommended.

Asunto(s)

Coxiella burnetii/aislamiento & purificación; Brotes de Enfermedades; Tamizaje Masivo; Complicaciones Infecciosas del Embarazo/diagnóstico; Fiebre Q/diagnóstico; Adulto; Análisis por Conglomerados; Brotes de Enfermedades/estadística & datos numéricos; Femenino; Humanos; Países Bajos/epidemiología; Embarazo; Complicaciones Infecciosas del Embarazo/epidemiología; Fiebre Q/complicaciones; Fiebre Q/epidemiología

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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Infecciosas del Embarazo / Fiebre Q / Tamizaje Masivo / Brotes de Enfermedades / Coxiella burnetii Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies / Screening_studies Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: Europa Idioma: En Revista: Euro Surveill Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2013 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Suecia

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