Maternal and foetal outcomes in women with gestational Dengue: A systematic review

Dengue is a mosquito-borne viral disease. It has been associated with high maternal and foetal morbidity and mortality. Therefore, this study aimed to describe the outcomes of Dengue infection in pregnant women in terms of maternal bleeding, miscarriage, preterm delivery, severe Dengue, Dengue shock and maternal mortality, as well as foetal outcomes in terms of foetal distress, low birth weight and neonatal mortality.

This systematic review followed PRISMA guidelines and was PROSPERO-registered (CRD42024578212). It examined publications from 2019-2024 across major databases, including Medline, Scopus, Web of Science, Scielo, and CENTRAL. The selection process utilised Rayyan AI^® for duplicate removal, followed by a two-reviewer screening system. The two reviewers initially filtered the papers by title and, then, by abstract; finally, they read the full text and chose the articles to synthesise. The same two reviewers performed data extraction independently using a Microsoft Excel^® matrix. For the risk of bias assessment and Quality evaluation, the ROBINS-E tool and the STROBE guidelines were employed.

Maternal Dengue was associated with an increased risk of preterm delivery and complications such as obstetric bleeding, especially postpartum haemorrhage, which was a complication that reached proportions of up to 25% in some studies. Severe Dengue and Dengue shock were also complications present in these women; thrombocytopenia was the most common sign, and complications such as pre-eclampsia and multi-organ dysfunction appeared, leading to fatal outcomes such as maternal and foetal mortality.

Dengue infection during gestation carries significant maternal health risks, including complications such as bleeding, miscarriage and preterm delivery. In addition, it is associated with foetal distress and low birth weight, as well as increased foetal and neonatal mortality, highlighting the need for vigilance and appropriate medical care.