Search tips
Search criteria 


Logo of bmjThe BMJ
BMJ. 1988 September 3; 297(6648): 584–587.
PMCID: PMC1834487

A prospective study of maternal and fetal outcome in acute Lassa fever infection during pregnancy.


Several viral infections have been reported to result in more severe disease in pregnant than non-pregnant women, but the relative risks have not been well characterised. This has now been done for Lassa fever in a prospective study of 68 pregnant and 79 non-pregnant women who were admitted to hospital in Sierra Leone with confirmed Lassa fever. Lassa fever was the main cause of maternal mortality in the hospital, accounting for 25% of maternal deaths. Twelve of 40 patients in the third trimester died, compared with two of 28 in the first two trimesters and 10 of 79 non-pregnant women. The odds ratio for death in the third trimester compared with the first two trimesters was 5.57 (95% confidence intervals 1.02 to 30.26). The condition of the mother improved rapidly after evacuation of the uterus, whether by spontaneous abortion, evacuation of retained products of conception, or normal delivery; 10 of 26 women without uterine evacuation died, but only four of 39 women with evacuation died (p = 0.0016). The odds ratio for death with pregnancy intact was 5.47 (95% confidence interval 1.35 to 22.16). Fetal and neonatal loss was 87%. The risk of death from Lassa fever in the third trimester is significantly higher than that in the first two trimesters and higher than that for non-pregnant women, but evacuation of the uterus can significantly improve the mother's chance of survival.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (944K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Brabin BJ. Epidemiology of infection in pregnancy. Rev Infect Dis. 1985 Sep-Oct;7(5):579–603. [PubMed]
  • Weinberg ED. Pregnancy-associated depression of cell-mediated immunity. Rev Infect Dis. 1984 Nov-Dec;6(6):814–831. [PubMed]
  • McCormick JB, Webb PA, Krebs JW, Johnson KM, Smith ES. A prospective study of the epidemiology and ecology of Lassa fever. J Infect Dis. 1987 Mar;155(3):437–444. [PubMed]
  • Walker DH, McCormick JB, Johnson KM, Webb PA, Komba-Kono G, Elliott LH, Gardner JJ. Pathologic and virologic study of fatal Lassa fever in man. Am J Pathol. 1982 Jun;107(3):349–356. [PubMed]
  • Johnson KM, McCormick JB, Webb PA, Smith ES, Elliott LH, King IJ. Clinical virology of Lassa fever in hospitalized patients. J Infect Dis. 1987 Mar;155(3):456–464. [PubMed]
  • Fraser DW, Campbell CC, Monath TP, Goff PA, Gregg MB. Lassa fever in the Eastern Province of Sierra Leone, 1970-1972. I. Epidemiologic studies. Am J Trop Med Hyg. 1974 Nov;23(6):1131–1139. [PubMed]
  • Keane E, Gilles HM. Lassa fever in Panguma Hospital, Sierra Leone, 1973-6. Br Med J. 1977 May 28;1(6073):1399–1402. [PMC free article] [PubMed]
  • McCormick JB, King IJ, Webb PA, Johnson KM, O'Sullivan R, Smith ES, Trippel S, Tong TC. A case-control study of the clinical diagnosis and course of Lassa fever. J Infect Dis. 1987 Mar;155(3):445–455. [PubMed]
  • McCormick JB, King IJ, Webb PA, Scribner CL, Craven RB, Johnson KM, Elliott LH, Belmont-Williams R. Lassa fever. Effective therapy with ribavirin. N Engl J Med. 1986 Jan 2;314(1):20–26. [PubMed]
  • Monath TP, Mertens PE, Patton R, Moser CR, Baum JJ, Pinneo L, Gary GW, Kissling RE. A hospital epidemic of Lassa fever in Zorzor, Liberia, March-April 1972. Am J Trop Med Hyg. 1973 Nov;22(6):773–779. [PubMed]
  • Smart YC, Cox J, Roberts TK, Brinsmead MW, Burton RC. Differential effect of cigarette smoking on recirculating T lymphocyte subsets in pregnant women. J Immunol. 1986 Jul 1;137(1):1–3. [PubMed]
  • Lederman MM. Cell-mediated immunity and pregnancy. Chest. 1984 Sep;86(3 Suppl):6S–9S. [PubMed]
  • Helmick CG, Webb PA, Scribner CL, Krebs JW, McCormick JB. No evidence for increased risk of Lassa fever infection in hospital staff. Lancet. 1986 Nov 22;2(8517):1202–1205. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Publishing Group