ASSOCIATION BETWEEN RECURRENT MISCARRIAGE AND RUBELLA VIRUS INFECTION AT THE JOS UNIVERSITY TEACHING HOSPITAL
BACKGROUND: Rubella virus infection is one of the common viral conditions in pregnancy that may result in recurrent fœtal wastage, fœtal death or congenital rubella syndrome. This is a frustrating experience which can be physically and emotionally tasking for couples.
OBJECTIVE: To compare the prevalence of rubella virus infection among women with recurrent pregnancy loss and normal post- natal women.
DESIGN : It was a hospital based case control study
METHODOLOGY : In this study 60 consenting women with recurrent pregnancy loss were recruited as cases, and another 60 consenting women presenting to the postnatal clinic following delivery of a healthy baby with no prior history of recurrent miscarriages, constituted the control group. Blood samples from cases and controls were analyzed for Rubella specific IgG and IgM using Enzyme Linked Iimmunosorbent Assay (ELISA) test kits. A semi-structured researcher administered questionnaire was used to obtain socio-demographic information which included; age, socioeconomic class, parity and gestational age at pregnancy loss. Data was analysed using Statistical Package for Social Sciences version 20. Statistical test employed Chi square and independent t test to determine significant difference between cases and controls. A p-value of less than 0.05 was considered significant.
RESULT: The study comprised of a total of 120 participants with an overall mean age of 30.62±3.60 years. The mean ages of the cases (participants with recurrent pregnancy loss) and controls in the study were 31.55±3.44 years and 29.68±3.55 years respectively. A total of 16 (26.7%) and 9 (15.0%) of the cases and controls respectively were aware of Rubella virus infection. None of the participants (0.0%) had received Rubella virus vaccination. The seroprevalence rates of Rubella IgG among women with recurrent miscarriage and normal women were 85% and 80% respectively. Also, Rubella IgM seroprevalence was higher among women with recurrent pregnancy loss (16.7%) in comparison to the controls (13.3%), There was no significant association between Rubella infection and miscarriage (p>0.05). A significantly higher proportion of the women with recurrent pregnancy loss had symptoms of fever and rash (18.3%) in comparison to the controls (1.7%) (p<0.05). The Anti-rubella serostatus identified among the cases and controls were IgG+IgM- (68.3% versus 66.7%), IgG+IgM+ (16.7% versus 13.3%), IgG-IgM-, (15.0% versus 20.0%). \
CONCLUSION: There is a high seroprevalence rate of Rubella in the study but poor level of awareness of Rubella virus in both women with recurrent pregnancy loss and normal controls. Hence, The seroprevalence of Rubella IgG among women with recurrent miscarriages and normal postnatal women was 85% and 80% respectively. There was no significant association between Rubella infection and recurrent miscarriages (P-value 0.609). The level of awareness of the respondents about Rubella was poor (20.8%). Due to the high seroprevalence of Rubella in the study, all pregnant women should screened and educated about Rubella and the methods of prevention. This will prevent seronegative (susceptible) individuals from becoming infected.