World Rural Health Conference
Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 3239
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents 
ORIGINAL ARTICLE
Year : 2013  |  Volume : 2  |  Issue : 1  |  Page : 44-46  

Seroprevalance of rubella in women with bad obstetric history


1 Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
2 Department of Microbiology, Sri Venkateswara Medical College, Tirupati, India

Date of Web Publication3-Apr-2013

Correspondence Address:
B V Ramana
Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507, Andhra Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.109943

Rights and Permissions
  Abstract 

Rubella is a common cause of rash and fever during childhood. However, its public health importance relates to the teratogenic effects of primary rubella infection occurring in pregnant women, which can lead to fetal death with spontaneous abortion or to congenital defects in surviving infants. Most of the cases are asymptomatic and difficult to diagnose on clinical grounds. Detection of specific IgM antibodies by the enzyme-linked immunosorbent assay (ELISA) technique is a useful method for diagnosis.The present study was conducted on 180 pregnant women attending antenatal clinics at Government Maternity Hospital, Tirupati. All the serum samples were tested for Rubella-specific IgM antibodies. A seropositivity of 12.67% was observed among cases with bad obstetric history and 6.67% in normal pregnant women. Within the test group, high sero-positivity (13.33%) was observed in women with repeated abortions followed by in cases of intrauterine death (12.73%). The results indicate high prevalence of rubella in our population. All antenatal cases should be routinely screened for rubella, so that early diagnosis will help in proper management and fetal outcome.

Keywords: Rubella IgM, bad obstetrical history, antenatal Care, intrauterine death


How to cite this article:
Ramana B V, Reddy B K, Murty D S, Vasudevanaidu K H. Seroprevalance of rubella in women with bad obstetric history. J Family Med Prim Care 2013;2:44-6

How to cite this URL:
Ramana B V, Reddy B K, Murty D S, Vasudevanaidu K H. Seroprevalance of rubella in women with bad obstetric history. J Family Med Prim Care [serial online] 2013 [cited 2019 Aug 21];2:44-6. Available from: http://www.jfmpc.com/text.asp?2013/2/1/44/109943


  Introduction Top


Rubella is a well-known viral disease which typically manifest as a self-limited disease characterized by erythematous maculopapular rash, low-grade fever, and mild respiratory symptoms. [1] Infection in any pregnant women can cause miscarriage, stillbirth, or multiple congenital rubella syndrome, characterized by cataract, patent ductus arteriosus, septaldefects, pulmonary artery stenosis, sensorineural deafness, meningoencephalitis, Intrauterine growth retardation (IUGR), and osseous changes. The major concern of this disease is that it can cause a serious, often fatal, congenital rubella syndrome (CRS) in newborns, especially when infection occurs during the first trimester. [1] The percentage of infection in the fetuses of mothers infected by Rubella during first trimester of pregnancy is greater than 80%. Seroprevalence of rubella infection in pregnant women in India varies from 6.5% in asymptomatic to 26.8% in pregnant females with bad obstetric history. Detection of specific IgM by enzyme-linked immunosorbent assay (ELISA) is a useful method for diagnosis of rubella infection and may be helpful in determining the causative role of rubella in abortions and still births. [2]


  Materials and Methods Top


A this study was conducted on 180 blood samples taken from antenatal women who attended Government Maternity Hospital, attached to Sri Venkateswara Medical College, Tirupati. The cases were divided into two groups. Group I (study group) included 150 blood samples from antenatal women in the reproductive age group with history of previous unfavorable fetal outcome in terms of two or more consecutive fetal deaths, intra-uterine growth retardation, still birth, early neonatal death, and/or congenital anomalies. In group II included blood from 30 antenatal women with normal pregnancy outcome in previous pregnancies as the control group. Among the test group, 90 samples were from antenatal women with history of repeated abortions, 55 from cases with history of intra uterine death, 4 from preterm delivery, and 1 from case with history of congenital anomalies during previous pregnancy. All the samples were screened for Rubella-specific IgM antibodies by ELISA using "RUB IgM" kit (Immuno Vision, USA) following the manufacturer's instructions.


  Results Top


Of the 180 samples tested, 150 were from women with Bad obstetric history (BOH) and the remaining 30 were from the women with previous normal deliveries. Of the test group, 12.67% (n=19) were positive whereas in the control group, 6.67% (n=2) were positive for IgM antibodies to Rubella [Table 1]. In our study within the test group highest percentage (13.33%) of sero-positivity was observed in pregnant women with repeated abortions followed by in intra-uterine death cases (12.73%). Twelve seropositive cases belong to pregnant women with history of abortion (13.33%) and seven seropositive cases belong to pregnant women with history of intrauterine death (12.73%) [Table 2].
Table 1: Results of IgM antibodies among test and control groups

Click here to view
Table 2: Test results among various subgroups of pregnant women with bad obstetric history

Click here to view



  Discussion Top


Infection with rubella virus can be disastrous in early gestation. The virus may affect all organs and cause a variety of congenital defects. Infection may lead to intra uterine death, spontaneous abortion, or preterm delivery. Infection with rubella virus is initially unapparent and asymptomatic and it is difficult to diagnose on clinical grounds. Several studies in India and other countries showed the seroprevalence of rubella as 4.66% to 28.6% in women of the reproductive age group. In India, pregnant women belonging to the low socioeconomic group may be exposed to a variety of infections due to poor environment and hygiene. Maternal infections such as rubella can be considered as a significant factor in the causation of poor pregnancy outcome. Ahmed et al. [3] at Karachi, Pakistan, reported that seropositivity for rubella IgM was 18% in women with BOH and 7% in normal pregnant women. [1] In another study, Cao et al. [4] at Hefei, China, reported that 16.29% were positive for rubella IgM antibodies. Yashodara et al. in Hyderabad reported that 11 (12.5%) cases were positive for rubella IgM antibodies. [2] Mathur et al. reported that 13.8% were positive for rubella IgM antibodies. [5] Ahmed et al. reported that 26.12% were positive for rubella IgM antibodies. [6] Chopra et al. reported that 17.5% women were positive for rubella IgM antibodies. [7] Naveen Thapliyal et al reported that 28.6% cases were positive for rubella IgM antibodies. [8] In the present study, 12.67% women were positive for Rubella IgM antibodies with previous bad obstetric history and the results were similar in the studies conducted in the same state Andhra Pradesh.

Kaur et al. at Maulana Azad Medical College, New Delhi, reported that the seropositivity for rubella IgM antibodies was 8.3% with previous normal delivery. [9] In another study conducted by Zheng et al. it was reported that the seropositivity was 7.4% (109/1471). [10] In the present study, 6.67% were positive for rubella IgM antibodies with previous normal delivery showing the similar findings. This indicates that the normal pregnant women may also have rubella antibodies. It is observed that there is considerable variation in the prevalence of rubella among women of childbearing age in different geographical areas in our country.


  Conclusions Top


The present study demonstrated a strong association between rubella infection and BOH in women. It is evident that maternal infection like rubella play a critical role in pregnancy wastage and their occurrence in women with BOH is a significant factor. A previous history of pregnancy wastage and a positive serological reaction during current pregnancy must be considered while managing BOH cases to reduce the adverse fetal outcome. Early detection and timely intervention can prevent morbidity and mortality of infants born to such mothers. All antenatal cases with BOH should be routinely screened for rubella, so that early diagnosis and appropriate intervention of these infections will help in proper management of fetal outcome. In addition to this, there is a need to modify vaccine strategies to immunize all adolescent girls and/or women of child-bearing age before conception to reduce incidence of congenital rubella syndrome and bad obstetric outcome.

 
  References Top

1.Boonruang S, Buppasiri P. Rubella antibodies in normal pregnant women at Srinagarind hospital, KhonKaen Thailand. J Med Assoc Thai 2005;88:455-9.  Back to cited text no. 1
    
2.Yashodhara P, Rama Lakshmi BA, Raman L, Nadamuni Naidu. Rubella IgM positivity during pregnancy. Indian J Med Microbiol 1998;16:121-2.  Back to cited text no. 2
    
3.Ahmed MU. IgM and IgG antibodies specific to rubella in child bearing women. J Pak Med Assoc 1992;42:121-2.  Back to cited text no. 3
    
4.Cao Y, Qiu L, Zhang Q. Study on the relationship between the history of abnormal pregnancy and TORCH infection in pregnant women. Zhonghua Fu Chan KeZaZhi 1999;34:517-20.  Back to cited text no. 4
    
5.Mathur MS, Rele MC, Turbadkar D. Seroprevalence of HIV infection in bad obstetrical history and its correlation with TORCH and VDRL. Proceedings of the XIV International AIDS Conference; 2002 July 7-12; Barcelona Spain.  Back to cited text no. 5
    
6.Fomda BA, Thokar MA, Farooq U, Sheikh A. Seroprevalence of rubella in pregnant women in Kashmir. Indian J Pathol Microbiol 2004;47:435-7.  Back to cited text no. 6
    
7.Chopra S, Arora U, Aggarwal A. Prevalence of IgM antibodies to toxoplasma, rubella and cytomegalovirus infections during pregnancy. J K Sci 2004;6:190-2.  Back to cited text no. 7
    
8.Thapliyal N, Shukla PK, Kumar B, Upadhyay S, Jain G. TORCH infection in women with bad obstetric history a pilot study in Kumaon region. Indian J Pathol Microbiol 2005;48:551-3.  Back to cited text no. 8
    
9.Kaur R, Gupta N, Nair D, Kakkar M, Mathur MD. Screening for TORCH infections in pregnant women: A report from Delhi. Southeast Asian J Trop Med Public Health 1999;30:284-6.  Back to cited text no. 9
    
10.Zheng F, Du J, HuY. A study of rubella infection during pregnancy. Zhonghua Fu Chan KeZaZhi 2002;37:391-4.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2]


This article has been cited by
1 The Seroprevalence of Toxoplasma, Cytomegalovirus and Rubella Infections in Women with Abortion in Kurdistan Region of Iraq: A Brief Report
Nawfal Hussein,Amer A Balatay
International Journal of Infection. 2019; In Press(In Press)
[Pubmed] | [DOI]
2 ToRCH “co-infections” are associated with increased risk of abortion in pregnant women
Sima Rasti,Fatemeh Sadat Ghasemi,Amir Abdoli,Ahmad Piroozmand,Seyed Gholam Abbas Mousavi,Zohreh Fakhrie-Kashan
Congenital Anomalies. 2016; 56(2): 73
[Pubmed] | [DOI]
3 Seroepidemiology of Rubella in Women Under 25 Years Old Attending Medical Centers in Ahvaz, Iran in 2013
Mehri Ghafourian,Abdolhussein Shakunia,Seyed Mohammad Alavi,Wesam Kooti,Ghodratollahe Shakerinejad,Amirarsalan Serajian,Zahra Chinipardaz
Jundishapur Journal of Microbiology. 2015; 8(12)
[Pubmed] | [DOI]
4 Systematic Review of Measles and Rubella Serology Studies
Kimberly M. Thompson,Cassie L. Odahowski
Risk Analysis. 2015; : n/a
[Pubmed] | [DOI]



 

Top
   
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion
Conclusions
References
Article Tables

 Article Access Statistics
    Viewed1547    
    Printed68    
    Emailed0    
    PDF Downloaded311    
    Comments [Add]    
    Cited by others 4    

Recommend this journal