Parvovirus B19 infection in pregnancy: perinatal outcomes derived from a systematic review and meta-analysis.
Sara Sorrenti, Eileen Deuster, Francesco D'Antonio et al.
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In 30 seconds
This systematic review and meta-analysis assessed fetal and perinatal outcomes associated with Parvovirus B19 infection in pregnancy and compared the 2023–2024 outbreak with earlier waves. It included 44 studies involving 3221 women and 748 fetuses with infection. Intrauterine demise was estimated at 38.7% (95% confidence interval, 27.3-51.6) among fetal infections, compared with 7.3% (95% confidence interval, 4.6-11.3) among maternal infections. The analysis found no significant difference between recent and previous waves in intrauterine demise or ultrasound signs of fetal anemia.
Key findings
- Intrauterine demise occurred in an estimated 38.7% (95% confidence interval, 27.3-51.6) of fetal infections and 7.3% (95% confidence interval, 4.6-11.3) of maternal infections.
- Intrauterine transfusion was performed in 34.9% (95% confidence interval, 21.9-50.7) of fetal infections and 15.3% (95% confidence interval, 7.9-27.6) of maternal infections.
- Among infected fetuses, hydrops was reported in 58.7% (95% confidence interval, 38.8-76.2); abnormal neuroimaging was found in 28.6% (95% confidence interval, 17.0-43.9) of those receiving prenatal magnetic resonance imaging.
- Recent versus previous waves showed no significant difference in intrauterine demise (odds ratio, 0.84; 95% confidence interval, 0.46-1.54; P=.58) or ultrasound signs of fetal anemia (odds ratio, 1.13; 95% confidence interval, 0.82-1.56; P=.46).
Why it matters
The pooled estimates illustrate that outcomes differ substantially according to whether infection is maternal or confirmed in the fetus, and quantify important fetal complications. The absence of a significant increase in intrauterine demise during the recent outbreak provides context for interpreting its outcomes. The reported neuroimaging findings also highlight a potential diagnostic consideration in selected cases, while not establishing its benefit.
What to keep in mind
The review pooled studies with differing populations and infection status; the authors state that large multicenter studies are needed to assess prenatal interventions and the role of neuroimaging.