Measles in pregnancy: clinical considerations & challenges. Systematic review.
Bibliographic record
Abstract
Background: Measles remains a highly contagious viral infection with significant morbidity and mortality. Pregnant women constitute a high-risk group, with infection associated with severe maternal illness, adverse pregnancy outcomes, and neonatal complications. Recent outbreaks and immunity gaps among women of reproductive age necessitate a synthesis of current evidence. Objective: To systematically review maternal, fetal, and neonatal outcomes associated with measles infection during pregnancy and summarize clinical and preventive considerations. Methods: A systematic search of PubMed, Embase, Google Scholar, and the Cochrane Library was conducted from inception to December 2025. Observational studies, outbreak investigations, case series (≥5 cases), and systematic reviews reporting measles during pregnancy were included. Outcomes assessed included maternal morbidity and mortality, pregnancy loss, preterm birth, neonatal morbidity, and congenital measles. Quality appraisal used the Newcastle-Ottawa Scale, Joanna Briggs Institute tools, and AMSTAR-2. This review was not prospectively registered. Results: Fifteen studies involving over 1,000 pregnant women with measles were included. Hospitalization rates ranged from 60% to 96%. Pneumonia occurred in 18–40% of cases and encephalitis in up to 5%. Maternal mortality reached 12% in outbreak settings, with pooled estimates of 4.3%. Adverse pregnancy outcomes were frequent, including spontaneous abortion, intrauterine fetal death, preterm birth (13–31%), and low birth weight. Adjusted risks for fetal loss and neonatal morbidity were significantly higher compared with uninfected pregnancies. Early gestational infection was associated predominantly with pregnancy loss, whereas late gestational infection increased the risk of preterm birth and congenital malformation. Neonatal outcomes included increased NICU admission and prolonged hospitalization. Conclusion: Measles in pregnancy is associated with substantial maternal and perinatal risk. Preconception immunization and timely post-exposure prophylaxis remain central preventive strategies. Implications and Future Research: Prospective pregnancy registries, vaccine-era cohort studies, and gestation-specific management protocols are required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.060 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".