Leptospirosis outcomes in pregnancy

Introduction: Leptospirosis is a serious disease of humans, caused by different strains of the ‎bacteria Leptospira. The disease in humans can include pregnant mothers with poor outcomes ‎such as intrauterine fetal death, abortion, and delivery of a newborn with signs of congenital ‎leptospirosis. Moreover, due to overlapping signs and symptoms, leptospirosis is often ‎difficult to distinguish from HELLP syndrome and Acute Fatty Liver of pregnancy. ‎Therefore, it's necessary to assess the effect of leptospirosis on pregnancy outcome in human.‎ Objective: The goal of this study was to review the articles relating to leptospirosis and ‎pregnancy outcomes.‎ Methods: Data were gathered via a number of electronic databases and books.‎ Results: Leptospirosis is the most widespread zoonosis in the world. In tropical regions, the ‎infection is endemic, while in industrialized countries, the disease is rare. Leptospirosis is ‎difficult to distinguish from many other diseases in humans. Human infection may be ‎subclinical or present with a wide spectrum of symptoms. Common symptoms in humans are ‎similar to influenza and include headache, joint and muscular ache and pain, gastrointestinal ‎discomfort, nausea, vomiting, sweating, high fever. Researches have reported few cases in ‎pregnant women and the effect on prenatal outcome. Intrauterine fetal death, abortion, ‎delivery of a newborn with signs of congenital leptospirosis, and developmental abnormality ‎has all been reported. It has been proven that the bacteria can pass to a baby via breast milk. It ‎has also been detected in placenta, amniotic fluid and umbilical cord blood. Where the mother ‎has suffered a severe illness the cytotoxic impact of leptospires combined with hemorrhagia ‎and pyrexia can be a primary cause of fetal mortality, usually via placental ischaemia. ‎ Conclusion: While leptospirosis is rare in pregnancy, we should consider this infection in ‎pregnant women developing acute liver dysfunction or acute infection without fever, besides ‎HELLP syndrome and Acute Fatty Liver of Pregnancy. ‎