PREGMPOX · Impact of MPXV infection on pregnancy outcome and newborn health

Pregnant women have an increased risk of severe mpox disease, however, the underlying mechanisms remain elusive. To better understand altered transmission pattern of MPXV and its impact on this vulnerable population, PREGMPOX aims to assess the extent of MPXV spreading among pregnant women in South Kivu and neighboring regions through both passive and active surveillance. Passive surveillance will utilize existing health data from local facilities, capturing reported cases, while active surveillance will involve direct community engagement to identify and document unreported cases. In sentinel study sites in hot spot areas, the prevalence of MPXV infection among pregnant women will be investigated and potential transmission routes determined. Moreover, our project aims to document and analyze adverse pregnancy outcomes associated with MPXV infection, such as spontaneous losses, stillbirths, preterm deliveries, and neonatal infection. MPXV+ pregnant women will be asked to participate in a cohort study where they will be followed until delivery to document pregnancy outcomes, maternal immune response, and virus abundance and pathological changes in the placenta. This will help to determine specific risk factors and modes and frequencies of vertical transmission to the unborn, and generate a list of clinical and immunological predictors for adverse outcomes for pregnant women and neonates. As a prerequisite to evaluate the safety of the MVA-BN vaccine and tecovirimat treatment in pregnant women, we will create a comprehensive register of adverse pregnancy outcomes, using a pharmacovigilance model to monitor and analyze adverse events following immunization and treatment. The results of our multidisciplinary studies will be crucial for developing guidelines and recommendations to manage mpox more effectively during pregnancy, and for potentially influencing global health policies.