ArticleBMC pregnancy and childbirth2026
Lassa fever in the shadow of pregnancy - a case-control study of clinical presentation, risk factors and outcomes in Southern Nigeria.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLassa fever during pregnancy poses a significant threat to maternal and perinatal health. Despite the high burden of Lassa fever transmission in Southern Nigeria, epidemiological evidence on Lassa fever during pregnancy remains limited. We examined the clinical presentation, risk factors, and outcomes of Lassa fever in pregnancy in Lassa Fever hotspots of Southern Nigeria using standard Lassa fever treatment centres.
methodsWe conducted a multi-centred, unmatched hospital-based case-control study among 43 RT-PCR-confirmed pregnant women with Lassa fever and 170 pregnant women without Lassa fever (case to control - 1:4) in Southern Nigeria. from Federal Medical Centre, Owo, Ondo State, and Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. Outcome variables were Lassa Fever in pregnancy and maternal and perinatal outcomes. Univariate, bivariate, and multivariate analyses were conducted at 5% level of significance.
resultsThe mean age of women was similar: 28.6 ± 5.9 (cases) and 29.4 ± 5.3 (controls) years. Most Lassa fever cases presented during the antenatal period. Clinical symptoms and signs were significantly associated with Lassa Fever in pregnancy, including fever (p < 0.001), breast pain (p < 0.001), body weakness (p = 0.001), chest pain (p < 0.001), and convulsions/loss of consciousness (p = 0.001). Unbooked ANC status: AOR: 52.2, 95% CI (10.8-253.3), Fever in index Pregnancy: AOR: 4.8, 95% CI (1.04-22.2), p-value: <0.001, Malaria in index Pregnancy: AOR: 9.8, 95% CI (1.91-50.0), were significant predictors of Lassa fever in pregnancy. Lassa fever during pregnancy significantly increased the risk of stillbirth RR - 18.7, 95%CI (4.3-81.0); premature delivery RR - 5.25, 95%CI (3.51-7.85); low birth weight RR - 8.41, 95%CI (4.46- 15.87); birth asphyxia (1 min) RR - 3.61, 95%CI (1.48-8.84); oliguria RR - 19.8, 95%CI (2.37-164.8); facial swelling RR 8.1, 95%CI (2.2-29.0).
conclusionLassa fever in pregnancy is a significant public health concern in Southern Nigeria and is associated with severe maternal and perinatal outcomes, including spontaneous abortion, stillbirth, preterm delivery, low birth weight, and maternal death. Our findings have strong implications for healthcare providers regarding a high index of clinical suspicion, prompt diagnosis, strengthened antenatal surveillance, and intensified preventive measures, especially in endemic regions.
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