Abstract
Travelling while pregnant poses many challenges due to the inherent risks and changing physiology in pregnancy; the risk to the fetus in-utero from maternal exposure to medicines and vaccines, and the risks and complications of delivery. At some travel destinations, medical resources to deal with pregnancy-related complications may be significantly different than Canadian standards. Pregnant women may be more susceptible to and/or more severely affected by certain infectious diseases due to changes in immunity and physiology. In addition, pregnancy may increase the risk of acquiring certain infections such as malaria, toxoplasmosis, leprosy and listeriosis (1). Similarly, certain infections such as influenza and varicella may have a more severe clinical course, an increased rate of complications and a higher case fatality rate. Some fungal infections such as coccidiodomycosis and blastomycosis are associated with a higher incidence of disseminated disease in pregnancy especially in the third trimester (2). The other major issue in advising pregnant travellers is that there is very little evidence based on randomized controlled studies and much of the information in the literature is theoretical. The following paper will outline the risks to the pregnant traveller and the current recommendations based upon the existing body of literature.
Highlights
Travelling while pregnant poses many challenges due to the inherent risks and changing physiology in pregnancy; the risk to the fetus in-utero from maternal exposure to medicines and vaccines, and the risks and complications of delivery
The following paper will outline the risks to the pregnant traveller and the current recommendations based upon the existing body of literature
A study of 101 Nigerian pregnant women in various stages of pregnancy, inadvertently administered Yellow fever (YF) vaccine, demonstrated no significant adverse effects on the fetus or an association with risk of fetal infection . (33) In this study the percentage of women who seroconverted after vaccination was significantly less than the non-pregnant group (39% vs. 82%) . (33) In a more recent study, 441 Brazilian pregnant women who were inadvertently vaccinated were followed through delivery and no adverse effects were demonstrated
Summary
Travelling while pregnant poses many challenges due to the inherent risks and changing physiology in pregnancy; the risk to the fetus in-utero from maternal exposure to medicines and vaccines, and the risks and complications of delivery. Parmi les 226 cas de vaccination par inadvertance de femmes enceintes qui ont été signalés aux CDC entre 1971 et 1989, on a observé une infection subclinique chez 1 à 2 % des fœtus, mais aucun cas de syndrome de rubéole congénitale . A study of 101 Nigerian pregnant women in various stages of pregnancy, inadvertently administered YF vaccine, demonstrated no significant adverse effects on the fetus or an association with risk of fetal infection . Dans le cadre d’une petite étude portant sur 39 femmes ayant reçu par inadvertance le vaccin contre la fièvre jaune au Brésil, certaines données indiquaient que les femmes enceintes qui reçoivent le vaccin au début de la grossesse présentent un risque accru d’avortement spontané . Measures should be used to reduce the risk of deep vein thrombosis such as support stockings and lower extremity leg movements
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