Pregnant Women and the Ebola Crisis

Abstract

(N Engl J Med. 2018;379:2492–2493) Knowledge of the effects of Ebola virus disease (EVD) in pregnant women remains severely limited, despite recent occurence of some of the largest Ebola outbreaks to date—the West Africa Ebola outbreak of 2014-2016 included 28,000 cases and claimed 11,000 lives, and in 2018, the 10th EVD outbreak since 1976 was reported in the Democratic Republic of Congo. Surveillance systems in place at those times did not record pregnancy status, which in turn complicated case-investigation and contact-tracing efforts. In fact, monitoring outcomes of pregnant women and newborns was completed primarily through anecdotal reports. Therefore, in order to establish evidence-based recommendations for the care of Ebola-infected pregnant women, the author of the current perspective article believes that documentation of pregnancy status, via urine testing or, at minimum, self-reporting, is needed for all women of reproductive age who present at Ebola treatment units or hospitals. Not only would these assessments ensure proper obstetrical care in emergency settings, but they would also strengthen national maternal and neonatal mortality surveillance systems and increase knowledge of the overall effects of outbreaks on health care systems.