Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study.

OBJECTIVE: To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN: Retrospective observational study. SETTING: Grenada. POPULATION: Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS: This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES: Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS: Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (µ = 898 days, σ = 277 days) compared with infections outside of pregnancy (µ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION: CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT: Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.

Buffer nitrogen solubility, in vitro ruminal partitioning of nitrogen and in vitro ruminal biological activity of tannins in leaves of four fodder tree species.

This study explores the chemical composition, buffer N solubility, in vitro ruminal N degradability and in vitro ruminal biological activity of tannins in leaves from Gliricidia sepium, Leucaena leucocephala, Morus alba and Trichanthera gigantea trees. These tree leaves are a potential protein source for ruminants, but their site-influenced nutritive value is largely unknown. Leucaena leucocephala leaves had the highest N content (42.1 g/kg DM), while T. gigantea leaves had the least (26.1 g/kg DM). Leucaena leucocephala had the highest buffer solubility index (20%), while 10% of the total N in leaves of the other three species was soluble. The rapidly fermentable N fraction 'a' was highest in M. alba leaves (734.9 g/kg DM) and least in T. gigantea leaves (139.5 g/kg DM). The rate of fermentation (c) was highest for M. alba (7%/hours) leaves. No significant correlations were recorded between buffer solubility index of N and in vitro ruminal N degradability parameters: a, b, and c. The highest response to tannin inactivation using polyethylene glycol, in terms of percentage increase in 36-hours cumulative gas production, was recorded in M. alba (39%) and T. gigantea (38%) leaves. It was concluded that buffer solubility of N is not a good indicator of ruminal N degradation in the leaves of these tree species. Leaves of M. alba could be more valuable as a source of rapidly fermentable N when animals are offered low-protein, high-fibre diets compared with other tree species evaluated in the current study. However, when feeding M. alba leaves, the role of tannins must be considered because these secondary plant compounds showed significant in vitro ruminal biological activity.