title: Preparing for biological threats: Addressing the needs of pregnant women.
abstract: Intentional release of infectious agents and biological weapons to cause illness and death has the potential to greatly impact pregnant women and their fetuses. We review what is known about the maternal and fetal effects of seven biological threats: Bacillus anthracis (anthrax); variola virus (smallpox); Clostridium botulinum toxin (botulism); Burkholderia mallei (glanders) and Burkholderia pseudomallei (melioidosis); Yersinia pestis (plague); Francisella tularensis (tularemia); and Rickettsia prowazekii (typhus). Evaluating the potential maternal, fetal, and infant consequences of an intentional release of an infectious agent requires an assessment of several key issues: (1) are pregnant women more susceptible to infection or illness compared to the general population?; (2) are pregnant women at increased risk for severe illness, morbidity, and mortality compared to the general population?; (3) does infection or illness during pregnancy place women, the fetus, or the infant at increased risk for adverse outcomes and how does this affect clinical management?; and (4) are the medical countermeasures recommended for the general population safe and effective during pregnancy? These issues help frame national guidance for the care of pregnant women during an intentional release of a biological threat. Birth Defects Research 109:391-398, 2017.© 2017 Wiley Periodicals, Inc.
authors.affiliation: University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Watson
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Sascha
authors.initials: S
authors.lastname: Ellington
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Christina
authors.initials: C
authors.lastname: Nelson
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Tracee
authors.initials: T
authors.lastname: Treadwell
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Meaney-Delman
mesh_terms: D000328:Adult; D000881:Anthrax / Q000382:microbiology; D001694:Biological Warfare / Q000517:prevention & control*; D054045:Biological Warfare Agents / Q000145:classification; D023482:Bioterrorism / Q000517:prevention & control*; D001906:Botulism / Q000382:microbiology; D005260:Female; D005896:Glanders / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008554:Melioidosis / Q000382:microbiology; D010930:Plague / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011297:Prenatal Exposure Delayed Effects / Q000517:prevention & control; D012899:Smallpox / Q000382:microbiology; D014406:Tularemia / Q000382:microbiology; D014438:Typhus, Epidemic Louse-Borne / Q000382:microbiology
chemical_list: D054045:Biological Warfare Agents
keywords: biologic; bioterrorism; biowarfare; infectious diseases; pregnant; threats