Pregnancy outcomes after snakebite envenomations: A retrospective cohort in the Brazilian Amazonia

PLoS Negl Trop Dis. 2022 Dec 5;16(12):e0010963. doi: 10.1371/journal.pntd.0010963. eCollection 2022 Dec.

Abstract

Snakebite envenomations (SBEs) in pregnant women can result in adverse maternal or neonatal effects, such as abortion, placental abruption, preterm labor, fetal malformations, and maternal, fetal or neonatal deaths. Despite the high incidence of SBEs in the Brazilian Amazon, there is no literature on the impact of SBEs on pregnancy outcomes. The objective of this study was to describe clinical epidemiology and outcomes associated with SBEs in women of childbearing age and pregnant women in the state of Amazonas, Western Brazilian Amazon, from 2007 to 2021. Information on the population was obtained from the Reporting Information System (SINAN), Mortality Information System (SIM) and Live Birth Information System (SINASC) for the period from 2007 to 2021. A total of 36,786 SBEs were reported, of which 3,297 (9%) involved women of childbearing age, and 274 (8.3%) involved pregnant women. Severity (7.9% in pregnant versus 8.7% in non-pregnant women) (P = 0.87) and case-fatality (0.4% in pregnant versus 0.3% in non-pregnant women) rates were similar between groups (P = 0.76). Pregnant women who suffered snakebites were at higher risk for fetal death (OR: 2.17, 95%CI: 1.74-2.67) and neonatal death (OR = 2.79, 95%CI: 2.26-3.40). This study had major limitations related to the completeness of the information on the pregnancy outcomes. Although SBE incidence in pregnant women is low in the Brazilian Amazon, SBEs increased the risk of fetal and neonatal deaths.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil
  • Female
  • Humans
  • Infant, Newborn
  • Perinatal Death*
  • Placenta
  • Pregnancy
  • Pregnancy Outcome
  • Retrospective Studies
  • Snake Bites* / complications
  • Snake Bites* / epidemiology

Grants and funding

J.S., M.B.P., and W.M.M. were funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq productivity scholarships). W.M.M. was funded by Fundação de Amparo à Pesquisa do Estado do Amazonas (PRÓ-ESTADO, call 011/2021 - PCGP/FAPEAM, call 010/2021 - CT&I ÁREAS PRIORITÁRIAS, call 003/2022 - PRODOC/FAPEAM, and POSGRAD) and by the Ministry of Health, Brazil (proposal No. 733781/19-035). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.