Published online March 1, 2006
PEDIATRICS Vol. 117 No. 3 March 2006, pp. 814-820 (doi:10.1542/peds.2005-1187)
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Arboviruses (also see West Nile...
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West Nile Virus Infection Among Pregnant Women in a Northern Colorado Community, 2003 to 2004

Jan E. Paisley, MDa,b, Alison F. Hinckley, PhDc, Daniel R. O'Leary, DVMc, William C. Kramer, BAa,b, Robert S. Lanciotti, PhDc, Grant L. Campbell, MD, PhDc and Edward B. Hayes, MDc

a Department of Pediatrics and Neonatology, University of Colorado Health Sciences Center, Denver, Colorado
b Department of Pediatrics and Neonatology, Poudre Valley Hospital, Fort Collins, Colorado
c Arboviral Diseases Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado

OBJECTIVE. Since West Nile virus (WNV) was first detected in New York in 1999, it has spread across North America and become a major public health concern. In 2002, the first documented case of intrauterine WNV infection was reported, involving an infant with severe brain abnormalities. To determine the frequencies of WNV infections during pregnancy and of intrauterine WNV infections, we measured WNV-specific antibodies in cord blood from infant deliveries after a community-wide epidemic of WNV disease.

METHODS. Five hundred sixty-six pregnant women who presented to Poudre Valley Hospital (Fort Collins, CO) for delivery between September 2003 and May 2004 provided demographic and health history data through self-administered questionnaires and hospital admission records. Umbilical cord blood was collected from 549 infants and screened for WNV-specific IgM and IgG antibodies with enzyme-linked immunosorbent assays, with confirmation by plaque-reduction neutralization tests. Newborn growth parameters, Apgar scores, and hearing test results were recorded.

RESULTS. Four percent (95% confidence interval: 2.4–5.7%) of cord blood samples tested positive for WNV-specific IgG antibodies. No cord blood samples were positive for WNV-specific IgM antibodies. There were no significant differences between infants of seropositive and seronegative mothers with respect to any of the growth parameters or outcomes measured.

CONCLUSIONS. Intrauterine WNV infections seemed to be infrequent. In our study, WNV infection during pregnancy did not seem to affect adversely infant health at birth. Larger prospective studies are necessary to measure more completely the effects of maternal WNV infection on pregnancy and infant health outcomes.

Key Words: West Nile virus • pregnancy • seroprevalence • congenital infection • perinatal transmission • breastfeeding • epidemiology

Abbreviations: WNV—West Nile virus • PVH—Poudre Valley Hospital • ELISA—enzyme-linked immunosorbent assay • PCR—polymerase chain reaction • PRNT—plaque-reduction neutralization test • JEV—Japanese encephalitis virus • SLEV—St Louis encephalitis virus • LBW—low birth weight • SGA—small for gestational age • YFV—yellow fever virus • CI—confidence interval • OR—odds ratio • CDC—Centers for Disease Control and Prevention

Accepted Aug 15, 2005.


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