Dengue in pregnancy and maternal mortality: a cohort analysis using routine data

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Dengue is a growing global public health concern, transmitted by mosquitoes.
• Its impact on maternal mortality remains poorly understood.
• Understanding dengue's role in pregnancy outcomes is crucial for targeted interventions.

Purpose of the Study:

• To investigate the association between symptomatic dengue during pregnancy and maternal death.
• To quantify the risk of maternal mortality linked to dengue infection in pregnant women.
• To inform public health strategies for protecting pregnant populations in dengue-endemic regions.

Main Methods:

• Population-based cohort study in Brazil (2007-2012).
• Linked confirmed dengue case records with maternal death records for women with live births.
• Employed the Firth method to estimate odds ratios for maternal death associated with dengue.

Main Results:

• Symptomatic dengue during pregnancy increased maternal death risk threefold (OR 3.0, 95% CI 1.5-5.8).
• Dengue hemorrhagic fever dramatically increased maternal death risk by 450 times (OR 450, 95% CI 186.9-1088.4).
• The heightened risk was most pronounced during the acute phase of dengue infection.

Conclusions:

• Dengue infection during pregnancy is associated with a significantly increased risk of maternal death.
• Pregnant women in dengue-endemic areas require heightened surveillance and prompt medical attention.
• Timely intervention by healthcare professionals is vital to mitigate adverse outcomes and prevent maternal deaths.