Perinatal outcomes of Parvovirus B19 infection in pregnancy: systematic review and meta-analysis

 

OBJECTIVES: To evaluate the fetal and perinatal outcomes of Parvovirus B19 infection in pregnancy, focusing on the differences between characteristics of the current disease outbreak observed in 2023-2024 and the previous waves.

METHODS: MEDLINE, EMBASE, Scopus, and CINHAL databases were searched up to December 2024. We performed a meta-analysis of pooled proportions using a random-effect model. All outcomes were described in the overall cohort, and a subgroup analysis was performed comparing cases from the most recent wave (2023-2024) and older cases. 

 

RESULTS: Forty-two studies were included. The rate of intrauterine demise among cases of fetal infection was 29.2% (95% CI 21.6-36.8), whereas the rate of demise among cases of maternal infection was lower (6.5%, 95% CI 4.7-8.3). The rate of termination of pregnancy in cases of fetal infection was 4.7% (95% CI 0.7-8.8). Intrauterine transfusion was performed in 36.7% of cases (95% CI 20.5-53.0) of fetal infections, and in 20.2% of cases of maternal infection (95% CI 5.7-34.8).

No significant difference was observed in the rate of fetal demise (OR 0.92, 95% CI 0.47-1.80, p=0.80) or ultrasound signs of fetal anaemia (OR 1.08, 95% CI 0.69-1.70, p=0.73) between the recent and the previous waves. The rate of IUTs was higher in the most recent wave, however statistical significance was not reached (OR 2.23, 95% CI 0.78-6.37, p=0.13).