Abstract
BackgroundDengue is a mosquito-borne disease that is common in many tropical and subtropical areas. Dengue infections can occur at any age and time in the lifespan, including during pregnancy. Few large scale studies have been conducted to determine the risk of preterm birth (PTB) and low birthweight (LBW) for infants born to women who had symptomatic dengue infection during pregnancy.Methodology/Principal FindingsThis study is a retrospective cohort study using medical records from 1992–2010 from pregnant women who attended a public regional referral hospital in western French Guiana. Exposed pregnancies were those with laboratory confirmed cases of dengue fever during pregnancy. Each of the 86 exposed infants was matched to the three unexposed births that immediately followed them to form a stratum. Conditional logistic regression was used to analyze these matched strata. Three groups were examined: all infants regardless of gestational age, only infants> = 17 weeks of gestational age and their strata, and only infants> = 22 weeks of age and their strata. Odds ratios were adjusted (aOR) for maternal age, maternal ethnicity, maternal gravidity, interpregnancy interval and maternal anemia. There was an increased risk of PTB among women with symptomatic dengue; (aOR all infants: 3.34 (1.13, 9.89), aOR 17 weeks: 1.89 (0.61, 5.87), aOR 22 weeks: 1.41 (0.39, 5.20)) but this risk was only statistically significant when all infants were examined (p value = 0.03). Adjusted results for LBW were similar, with an increased risk in the exposed group (aOR All infants: 2.23 (1.01, 4.90), aOR 17 weeks: 1.67 (0.71, 3.93), aOR 22 weeks: 1.43 (0.56, 3.70)) which was only statistically significant when all infants were examined (p value = 0.05).Conclusions/SignificanceSymptomatic dengue infection during pregnancy may increase the risk of PTB and LBW for infants. More research is needed to confirm these results and to examine the role of dengue fever in miscarriage.
Highlights
Dengue is a mosquito-transmitted viral infection that is common in most tropical and sub-tropical areas
The Tulane University Institutional Review Board approved this study as an exempt study for which informed consent was not Previous studies have reported that dengue fever during pregnancy may be related to preterm birth and low birthweight among infants
In this study there was an increased risk among pregnant women with symptomatic dengue to deliver infants who are preterm or low birthweight, but both the amount of risk and the stability of this risk were affected by the inclusion or exclusion of miscarriages This suggests that women who are pregnant should take extra precautions to avoid dengue infections during pregnancy, since it may cause an early delivery, or the birth of a small infant
Summary
Dengue is a mosquito-transmitted viral infection that is common in most tropical and sub-tropical areas. Concern regarding women who are pregnant becoming infected with dengue has been heightened in recent years due to an increase in adolescent and adult infections [3,4]. It is unclear if dengue infection in a pregnant woman results in serious health consequences for the mother or the child. Previous research has suggested higher proportions of preterm birth and low birth weight in infants born to mothers who had dengue during pregnancy [5,6,7]. Few large scale studies have been conducted to determine the risk of preterm birth (PTB) and low birthweight (LBW) for infants born to women who had symptomatic dengue infection during pregnancy
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