Prospective evaluation of pregnant women vaccinated against rubella in southern Brazil.

The rubella virus is a potent human teratogen. The highest risk of this infection occurs during pregnancy, as the virus may cause fetal damage known as congenital rubella syndrome (CRS). Since the rubella vaccine is made with attenuated live virus, there is a high level of anxiety concerning exposure during pregnancy. Although no case of CRS has been proved in children of immunized susceptible pregnant women, a risk below 1.6% cannot be ruled out. Our main purpose was to evaluate the occurrence of CRS in women who were vaccinated against rubella and did not know that they were pregnant, or became pregnant within 30 days after vaccination. We collected, prospectively, data on 171 pregnant women who were susceptible at the time of vaccination and compared them with data on the total population of pregnant women in the state of Rio Grande do Sul (RS), Brazil. A serologic sample was collected in 149 infants of susceptible mothers. A total of 10 infants (6.7%) had anti-rubella antibodies. When these were compared with the results obtained in the total population of births in RS, no difference was found in mean birth weight, low birth weight and sex. None of the ten infants with IgM(+) presented congenital defects involving CRS, during the physical examinations performed at the time of birth and at 3 months of age. Our study allows the safety of rubella vaccination to be extended to pregnant women.

Avaliação prospectica de gestantes vacinadas contra rubéola no sul do Brasil / Prospective evaluation of pregnant women that received rubella vaccine in south

Objetivos: Avaliar a ocorrência de Síndrome da Rubéola Congênita em mulheres que foram vacinadas contra rubéola e que não sabiam que estavam grávidas, ou que engravidaram até 30 dias após a vacinação. Métodos: foram coletados, prospectivamente, dados de 171 gestantes que se encontravam suscetíveis no momento da vacinação. No momento do parto foi colhido sangue dos recém-nascidos para exames. Todos os bebês com IgM anti rubéola positiva foram clinicamente avaliados conforme protocolo para detecção de sequelas da síndrome da rubéola congênita. Foi realizada a coleta de secreção nasofaríngea para isolamento e identificação viral. Resultados: foi coletada amostra sorológica de 152 bebês, filhos de mãe suscetíveis. Um total de 10 bebês (6,3%) apresentou presença de anticorpos IgM anti-rubéola, ou seja, foram infectados pelo vírus vacinal durante a gestação. Nenhum deles apresentou defeitos congênitos relacionados à rubéola. Conclusões: o estudo permite ampliar a segurança da vacinação para rubéola em mulheres grávidas.

Reproductive risk factors related to socioeconomic status in pregnant women in southern Brazil.

To evaluate patterns of drug use during pregnancy and other potential reproductive risks in pregnant women, we applied a standard questionnaire to 412 pregnant women classified as low socioeconomic status (SES) or as middle/high SES, in two cities of South Brazil. 77% of the women used at least one medication during pregnancy. We observed significant differences, when comparing low SES and middle/high SES groups, for the following variables: teenage pregnancies (28.4 vs. 12.4%); self-medication (21.8 vs. 13.1%); smoking habits (21.5 vs. 5.1%); unplanned pregnancies (69.5 vs. 51.8%); unwanted pregnancies (31.3 vs. 10.9%), and abortion attempts (13.1 vs. 5.8%). The average number of drugs consumed, however, was not different between low SES and middle/high SES. We believe that better education and conditions for family planning are key points to improve this scenario.