Review Article

Cholera Infection Risks and Cholera Vaccine Safety in Pregnancy

Table 1

Outcomes and risk factors of cholera during pregnancy based on included studies.

AuthorCountryOutcomes of cholera in pregnancyRisk factors of cholera in fetus

Ciglenecki et al. [18], Schillberg et al. [17]Haiti86% of pregnant women were discharged with a preserved pregnancy, and 6% had live full-term singleton births, of whom 2 died within the first 5 days postpartum. The remaining pregnancies (8%) resulted in intrauterine fetal death [18]The strongest risk factor for fetal death was severe maternal dehydration, followed by severe vomiting
Risk factors for complications of cholera in pregnant women were third trimester, younger maternal age, severe dehydration, and vomiting [17]

Nguyen-Toan Tran et al. [8]SwitzerlandThe pooled maternal death rate for 1991-2013 studies was 0.2% (95% CI: 0.0-0.7) and 5.0% (95% CI: 0.0-16.0) for 1969-1990The pooled fetal death rate for 4 studies during 1991-2013 was 7.9%, significantly lower than that of 3 studies from 1969 to 1990

Grout et al. [20], Moro et al. [16], Ali et al. [13], Davis et al. [5], and Wierzba et al. [19]USAPregnant women are at risk of severe diarrheal disease that can result in dehydration and pregnancy loss [16]
They are at risk of premature childbirth, or maternal death if the patient is not treated properly [13], fetal acidosis and hypoxia [5], and fetal distress and death [19]
Fetal malformations

Zhang et al. [21]ChinaNAThere was no association of pregnant women infected with cholera with an increased risk of preterm delivery, low birthweight, accidental abortion, or malformation

Khan et al. [15], Khan et al. [12]BangladeshPregnancy loss with magnitude varying from 2 to 36%
Adverse outcomes of pregnancy with infection of cholera
No association

Hashim et al. [14]KoreaAbortions, premature childbirth, and maternal deathNo association

Friedrich et al. [22]MalawiMiscarriage and stillbirthsNo association