Nationwide registry-based ecological analysis of Q fever incidence and pregnancy outcome during an outbreak in the Netherlands.
Bottom Line: In contrast, we found a weak significant association between residing in a Q fever-affected area in 2008-2010 and small for gestational age (adjusted OR 1.06 (95% CI 1.01 to 1.12)), with a population-attributable fraction of 0.70% (95% CI 0.07% to 1.34%).This study found a weak association between residing in a Q fever-affected area and the pregnancy outcome small for gestational age.Early detection of infection would require mass screening of pregnant women; this does not seem to be justified considering these results, and the uncertainties about its efficacy and the adverse effects of antibiotic treatment.
Affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.Show MeSH
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Mentions: Areas not affected by Q fever were selected in two stages. First, four-digit postal-code areas with zero Q fever notifications in 2008 through 2010 were identified. Then, for each Q fever-affected area, we selected three postal-code areas not affected by Q fever (figure 1), which resembled the affected area in their proportion of adverse pregnancy outcomes in 2003 through 2004 (before the Q fever outbreak). With this method, we created two area types (areas affected and not affected by Q fever) which were comparable with respect to the risk of obstetric complications before the start of the Q fever outbreak.
Affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.