Arboviruses in pregnancy: consequences of maternal and fetal infection

Abstract

Epidemics and localised outbreaks of infections due to arthropod borne (arbo) viruses, have been described for hundreds of years. Few viruses to date are known to transmit from mother to fetus, causing either teratogenic effects or fetal demise (see recent reviews Charlier et al. Effects on the fetus and newbornIt remains uncertain whether arboviral infection causes fetal damage through direct fetal infection when it occurs, and/or as a result of placental dysfunction causing fetal damage through malnutrition and reduced function, as occurs in other congenital infections 12,13 .The fetal and neonatal disease caused by arbovirus infection includes fetal demise, premature birth, and neurodevelopmental defects from viral teratogenicity. The latter has been recognised particularly with ZIKV and Venezuelan equine encephalitis (VEE) virus infections, as summarised in Table 1, and in recent reviews 1,2 .Ross River Virus infection may cause fetal infection, although it is uncertain if fetal disease results [14][15][16] . DENV is the most common arboviral infection globally, and is associated with severe illness in utero, including premature birth (21% versus background rate 11.5%), and miscarriage particularly during the first trimester (T1), and fetal death (13% versus background in utero death rate of 1.8%) 11. .