Abstract
This case describes rare preterm newborn survival in the setting of an
Ebola treatment unit in Eastern DRC. The neonate was born vaginally to
an acutely ill 17-year-old mother who was vaccinated against Ebola virus
after being identified as a contact of her father, who was a confirmed
case and who did not survive his infection. This woman was admitted to
an Ebola treatment unit at 32 weeks of gestation and given monoclonal
antibody treatment. She gave birth vaginally, succumbing to postpartum
hemorrhage 14 hours after delivery. This child survived despite
compounding vulnerabilities of preterm birth and maternal Ebola
infection. Despite a negative test for EVD, the neonate was given a
single dose of monoclonal antibody therapy in the first days of life. We
believe maternal vaccination and neonatal monoclonal antibody treatment
contributed to the child’s survival. The circumstances surrounding
neonatal survival in this extremely resource-limited context must be
analyzed and disseminated in order to increase rates of neonatal and
maternal survival in future outbreaks. Maternal and neonatal health are
critical aspects of outbreak response that have been understudied and
underreported leaving clinicians severely underresourced to provide
life-saving care in outbreak settings. Pregnancy and childbirth do not
stop in times of disease outbreak, adequate equipment and trained staff
required for quality neonatal care must be considered in future outbreak
responses.
Key words: Ebola and pregnancy, preterm delivery, neonatal
survival, limited resources, Democratic Republic of Congo.