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A prospective matched study on symptomatic dengue in pregnancy
Célia Basurko1,2, Sibille Everhard1, Séverine Matheus3
1Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France.
Plos One
|October 4, 2018
Summary
Dengue during pregnancy can lead to complications, especially severe maternal dengue with warning signs, which increases the risk of peripartum hemorrhage. Increased vigilance is crucial for pregnant women diagnosed with dengue.
Area of Science:
- * Infectious Diseases
- * Obstetrics and Gynecology
- * Epidemiology
Background:
- * Dengue fever is a growing global health concern, yet its effects on pregnancy outcomes are not well understood.
- * Existing research on dengue in pregnancy is often limited by methodological biases, impacting clinical recommendations.
- * Understanding dengue's impact on pregnant individuals is crucial for public health strategies and improved maternal care.
Purpose of the Study:
- * To investigate the association between symptomatic dengue infection during pregnancy and various maternal and fetal outcomes.
- * To compare pregnancy events and outcomes in women with dengue versus those without during an epidemic.
- * To identify specific risk factors and complications associated with dengue in pregnant women.
Main Methods:
- * A matched cohort study was conducted in French Guiana during a dengue epidemic.
- * Pregnant women with symptomatic dengue (n=73) were matched with women without dengue (n=219) based on follow-up location, gestational age, and residence.
- * Dengue confirmation involved detecting viral RNA, NS1 antigen, or specific antibody responses; outcomes were analyzed using multivariate analysis.
Main Results:
- * Maternal dengue with warning signs was identified as a significant risk factor for peripartum hemorrhage (adjusted relative risk = 8.6).
- * No significant associations were found between dengue exposure during pregnancy and prematurity, small for gestational age infants, hypertension, or emergency Cesarean section.
- * A near-significant association was observed between dengue infection and in utero death (p=0.09).
Conclusions:
- * Symptomatic dengue during pregnancy, particularly with warning signs, necessitates increased medical vigilance due to risks like peripartum hemorrhage.
- * The study highlights the importance of controlling for confounders when assessing dengue's impact on obstetrical events.
- * Pregnant women experiencing dengue require close monitoring, especially those with severe symptoms, to mitigate potential adverse outcomes.
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