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

• Published in: PLOS Neglected Tropical Diseases
• Main Authors: Thaís P Nascimento, Alexandre Vilhena Silva-Neto, Djane Clarys Baia-da-Silva, Patrícia Carvalho da Silva Balieiro, Antônio Alcirley da Silva Baleiro, Jacqueline Sachett, Lisele Brasileiro, Marco A Sartim, Flor Ernestina Martinez-Espinosa, Fan Hui Wen, Manuela B Pucca, Charles J Gerardo, Vanderson S Sampaio, Priscila Ferreira de Aquino, Wuelton M Monteiro
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science (PLoS) 2022
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doi.org/10.1371/journal.pntd.0010963; https://doaj.org/article/4b1d8dff87994ddd802d1a6f920bf904

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.