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Vertical transmission, which occurs most commonly through prolonged breastfeeding and rarely during pregnancy, or childbirth, perpetuates the virus within families. This observational, retrospective study analyzed HTLV-1-infected and uninfected pregnant women admitted for delivery at a university maternity hospital in Salvador, Brazil (2020\u20132022). Medical records provided sociodemographic, clinical, and laboratory data. The HTLV-1 infection rate was 4.61 per 1000 deliveries. The sociodemographic characteristics were similar between infected (n = 17) and uninfected (n = 34) women. HTLV-1-positive women had higher rates of unplanned and undesired pregnancies. Adverse pregnancy outcomes were frequent in both groups (94.1% vs. 91.2%), but metabolic disorders and hypertension\/eclampsia were more common among the infected women. Preterm birth and postpartum complications were also more frequent (17.6% vs. 5.9%, respectively), although the difference was not statistically significant. Breastfeeding initiation within the first hours of life was lower among exposed newborns (28.6% vs. 70%; p = 0.013). Neonatal characteristics did not differ significantly between the groups. These findings highlight critical gaps in reproductive health awareness and barriers to accessing preventive interventions. Further research on therapeutic strategies is urgently needed to support the World Health Organization\u2019s (WHO) goal of eliminating HTLV-1 vertical transmission by 2030.<\/jats:p>","DOI":"10.3390\/pathogens14040389","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T04:05:31Z","timestamp":1744776331000},"page":"389","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["HTLV-1 and Pregnancy: A Retrospective Study of Maternal and Neonatal Health Outcomes in an Endemic Region of Brazil"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4586-8087","authenticated-orcid":false,"given":"Jacielma","family":"de Oliveira Freire","sequence":"first","affiliation":[{"name":"Escola Bahiana de Medicina e Sa\u00fade P\u00fablica\u2014EBMSP, Salvador 40290-000, Bahia, Brazil"},{"name":"Maternidade Clim\u00e9rio de Oliveira, Universidade Federal da Bahia-UFBa\/Empresa Brasileira de Servi\u00e7os Hospitalares (EBSERH), Salvador 40055-150, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Aparecida","family":"Figueredo Rodrigues","sequence":"additional","affiliation":[{"name":"Escola Bahiana de Medicina e Sa\u00fade P\u00fablica\u2014EBMSP, Salvador 40290-000, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6066-6344","authenticated-orcid":false,"given":"Greice Carolina","family":"Santos da Silva","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Gon\u00e7alo Moniz\u2014Fiocruz\/IGM, Salvador 40296-710, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8402-6416","authenticated-orcid":false,"given":"Hugo Saba Pereira","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Departamento de Ci\u00eancias Exatas e da Terra, Universidade do Estado da Bahia\u2014UNEB, Salvador 41150-000, Bahia, Brazil"},{"name":"Servi\u00e7o Nacional de Aprendizagem Industrial, Campus Integrado de Manufatura e Tecnologias\u2014SENAI CIMATEC, Salvador 41650-010, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2376-0160","authenticated-orcid":false,"given":"Marcio Luis Valen\u00e7a","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Instituto Federal da Bahia\u2014IFBA, Salvador 40301-015, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5601-8459","authenticated-orcid":false,"given":"Alo\u00edsio","family":"Santos Nascimento Filho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o Nacional de Aprendizagem Industrial, Campus Integrado de Manufatura e Tecnologias\u2014SENAI CIMATEC, Salvador 41650-010, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5467-6083","authenticated-orcid":false,"given":"Briena","family":"Rodrigues Santos","sequence":"additional","affiliation":[{"name":"Escola Bahiana de Medicina e Sa\u00fade P\u00fablica\u2014EBMSP, Salvador 40290-000, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria da Concei\u00e7\u00e3o","family":"Chagas de Almeida","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Gon\u00e7alo Moniz\u2014Fiocruz\/IGM, Salvador 40296-710, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Galv\u00e3o-Castro","sequence":"additional","affiliation":[{"name":"Escola Bahiana de Medicina e Sa\u00fade P\u00fablica\u2014EBMSP, Salvador 40290-000, Bahia, Brazil"},{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Gon\u00e7alo Moniz\u2014Fiocruz\/IGM, Salvador 40296-710, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7356-5569","authenticated-orcid":false,"given":"Maria Fernanda Rios","family":"Grassi","sequence":"additional","affiliation":[{"name":"Escola Bahiana de Medicina e Sa\u00fade P\u00fablica\u2014EBMSP, Salvador 40290-000, Bahia, Brazil"},{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Gon\u00e7alo Moniz\u2014Fiocruz\/IGM, Salvador 40296-710, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/hon.2900040104","article-title":"Human t-cell leukemia virus: Causative roles in development of adult t-cell leukemia and provirus integration into leukemic cell DNA","volume":"4","author":"Yoshida","year":"1986","journal-title":"Hematol. 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