INCREASED PERINATAL MORTALITY AMONG CHILDREN OF MOTHERS EXPOSED TO MEASLES DURING PREGNANCY

A survey done after a severe epidemic of measles in an urban area of Guinea-Bissau has shown that children born to women exposed to measles during pregnancy had a perinatal mortality rate of 15%, compared with only 4% for other children in the community (OR=4·2; 95% CI 2·1-8·5). None of the women had clinical evidence of measles. Adjusting for background variables, logistic regression analysis showed no tendency towards reduced risk of perinatal mortality among children of women exposed during pregnancy relative to controls. Both stillbirth and early neonatal mortality rates were increased. A similar tendency was found in a rural epidemic (OR=9·5; 95% CI 2·6-35·1). Exposure during any trimester of fetal life increased the rate of perinatal mortality. The results suggest that exposure to measles virus or some concomitantly transmitted pathogen may contribute to the high perinatal mortality risk found in many developing countries. The possible long-term health consequences of exposure to measles virus should be considered when assessing the value of measles control programmes.