ArticleBMJ open2015
Nationwide registry-based ecological analysis of Q fever incidence and pregnancy outcome during an outbreak in the Netherlands.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 19 citations in OpenAlex.
- Two Cases of Q Fever in Pregnancy, including Management of the Newborn, Australia.Emerging infectious diseases · 2026Review
- Infection and Persistence ofInternational journal of molecular sciences · 2023Article
- Serological Prevalence of and Risk Factors forInternational journal of environmental research and public health · 2022Article
- Pregnancy outcomes of Q fever: prospective follow-up study on Reunion island.BMC infectious diseases · 2019Article
- Seroprevalence of Q fever in cattle, sheep and goats in the Volta region of Ghana.Veterinary medicine and science · 2019Article
- Clinical Features and Complications of Coxiella burnetii Infections From the French National Reference Center for Q Fever.JAMA network open · 2018Article
- From Q Fever to Coxiella burnetii Infection: a Paradigm Change.Clinical microbiology reviews · 2017Review
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWhether areas affected by Q fever during a large outbreak (2008-2010) had higher rates of adverse pregnancy outcomes than areas not affected by Q fever.
designNationwide registry-based ecological study.
settingPregnant women in areas affected and not affected by Q fever in the Netherlands, 2003-2004 and 2008-2010.
participantsIndex group (N=58,737): pregnant women in 307 areas with more than two Q fever notifications. Reference group (N=310,635): pregnant women in 921 areas without Q fever notifications. As a baseline, pregnant women in index and reference areas in the years 2003-2004 were also included in the reference group to estimate the effect of Q fever in 2008-2010, and not the already existing differences before the outbreak.
main outcome measuresPreterm delivery, small for gestational age, perinatal mortality.
resultsIn 2008-2010, there was no association between residing in a Q fever-affected area and both preterm delivery (adjusted OR 1.01 (95% CI 0.94 to 1.08)), and perinatal mortality (adjusted OR 0.87 (95% CI 0.72 to 1.05)). 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%). We observed no dose-response relation for this outcome with increasing Q fever notifications, and we did not find a stronger association for women who were in their first trimester of pregnancy during the months of high human Q fever incidence.
conclusionsThis 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.
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