Leptospirosis in pregnancy: Prevalence and outcome

Abstract

Introduction: Leptospirosis is considered as most widespread zoonotic disease in the world. Infection in pregnant women may be grave leading to severe fetal and maternal mortality. The presentation may mimic other viral, bacterial and parasitic infections, acute fatty liver, pregnancy-induced hypertension, and HELLP syndrome. Objective: Diagnosis of Leptospirosis by ELISA and multiplex PCR for sec Y genes in antenatal patients with fever of 15 days duration and to assess the prevalence of Leptospirosis in the pre-determined group. To compare outcome of pregnancy in the predetermined groups. Materials and Methods: The study was conducted in the Department of Microbiology and Department of Obstetrics and Gynaecology and necessary required expertise from the Department of Medicine, JNMCH, AMU for a period of 3 years, from September 2016 to August 2018. Pregnant females attending the Antenatal Clinic during 9 months of pregnancy were included in the study and followed for fetal outcome. Laboratory diagnosis of leptospirosis was done by IgM ELISA Pan BIO and MULTIPLEX PCR for Sec Y genes. Result: In our study ELISA test was performed on 130 suspected antenatal female patients for Leptospirosis. It was observed that out of 130 cases, ELISA was reactive in 14 (10.76) patients and nonreactive in 116 (89.23) patients while none of the patient in control was reactive by ELISA. Patients were followed for outcome of pregnancy. Most of the patients delivered by vaginal route 7 (50%), 3 (21.42%) underwent cesarean section, 3 (21.42%) cases had abortion and 1 (7.14%) patient gave stillbirth. Birth weight of live babies born to antenatal females suspected of Leptospirosis categorised into 0 (0%) babies were Extremely Low Birth Weight (ELBW) ( 3 (30%) were Low Birth Weight(LBW) ( (10%) Large for Gestational Age (LGA) (4 kg). Conclusion: The hazards of leptospirosis during pregnancy include intrauterine infection with fetal death and abortion, stillbirth, premature labour and signs o