Incidence and outcomes of dengue in a cohort of pregnant women from an endemic region of India: obesity could be a potential risk for adverse outcomes

Nujum, Zinia T; Chellamma, Nirmala; Vijayakumar, Krishnapillai; Beegum, M Saboora; Jyothi, R

doi:10.1093/trstmh/trz003

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…These findings extended our understanding of the epidemic of dengue fever in pregnant women and its risk factors, which is of great significance for preventing dengue infection and the potential adverse consequences in pregnant women. The positive prevalence of dengue IgG antibody was 2.22% in current study, which was much lower than that in pregnant women of some countries such as India (30.41%) (7) and Malaysia (32.4%) (8). This is probably since dengue is not an endemic disease in Guangdong Province, and imported cases are one of the main causes of local outbreaks of dengue fever in Guangdong.…”

Section: Discussioncontrasting

confidence: 61%

“…It is worth noting that pregnant woman is a susceptible group in dengue-endemic areas. Evidence from India, Malaysia, and Brazil showed that the positive rate of serum DENV immunoglobulin G (IgG) antibodies in pregnant women were as high as 30.41, 32.4, and 53.9%, respectively (7)(8)(9). After infection of DENV, a higher risk of severe dengue fever was observed in pregnant women than in other groups of people (10).…”

Section: Introductionmentioning

confidence: 99%

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The Seroprevalence of Dengue Virus Infection and Its Association With Iron (Fe) Level in Pregnant Women in Guangzhou, China

Wang

Sun

et al. 2021

Front. Med.

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Dengue fever is regarded as the most prevalent mosquito-borne viral disease in humans. However, information of dengue virus (DENV) infection in pregnant women and the influence factors remain unclear. In this study, we extracted information of 2,076 pregnant women from the Prenatal Environment and Offspring Health (PEOH) birth cohort conducted since 2016 in Guangzhou, China. Peripheral blood and clean midstream urine samples of participants were collected during their hospitalization for childbirth. Indirect enzyme-linked immunosorbent assay (ELISA) was used to detect immunoglobulin G (IgG) antibodies of DENV in serum samples, and inductively coupled plasma mass spectrometry (ICP-MS) was applied to determine the Fe concentrations in the urine samples, which were then adjusted for by urine creatinine and transformed by natural logarithm (ln-Fe). The seroprevalence of DENV IgG antibody in all included participants was 2.22% (46/2,076). We observed higher seroprevalence of IgG antibody in women aged ≥35 years (2.9%), education ≤ 12 years (2.5%), yearly income per capita <100,000 yuan (2.4%), no use of air-conditioner (2.4%), no use of mosquito coils (2.3%), and no exercise during pregnancy (4.1%). A U-shaped relationship was found between ln-Fe concentration and the risk of positive IgG antibody. Compared with women with ln-Fe concentration of 2.0–2.9 μg/g creatinine, slightly higher risks of positive IgG antibody were found among women with ≤2.0 (RR = 4.16, 95% CI: 0.78, 19.91), 3.0–3.9 (RR = 1.93, 95% CI: 0.65, 7.08), 4.0–4.9 (RR = 2.19, 95% CI: 0.65, 8.51), and ≥5.0 μg/g creatinine of ln-Fe (RR = 2.42, 95% CI: 0.46, 11.33). Our findings suggested that the seroprevalence of dengue IgG antibody in pregnant women was comparable to the general population in Guangzhou, China. The risk of DENV infection may be associated with maternal demographic characteristics and behaviors. Both maternal low and high Fe concentrations may be positively associated with the risk of DENV infection.

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Section: Discussioncontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

The Seroprevalence of Dengue Virus Infection and Its Association With Iron (Fe) Level in Pregnant Women in Guangzhou, China

Wang

Sun

et al. 2021

Front. Med.

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“…23 In the present study, one preterm baby born to a DENV positive mother was recorded. Other Indian studies have also reported preterm deliveries, abortions, and fetal NICU admissions associated with maternal DENV infections 20,25 and therefore prospective studies are required to explain these differences, which may be due to viral, genetic, or cultural factors.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Dengue, Chikungunya, and Zika Viruses in Febrile Pregnant Women: An Observational Study at a Tertiary Care Hospital in North India

Gupta

Jain

Venkatesh

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) are arboviruses that can affect maternal and fetal outcome if acquired during pregnancy. This study was done to estimate the positivity of DENV, CHIKV, and ZIKV in febrile pregnant women attending a tertiary care hospital in north India. Symptomatic pregnant women were tested for these viruses by IgM ELISA and/or by Trioplex real-time polymerase chain reaction. Their symptoms and laboratory parameters were recorded and were followed up till delivery to know their immediate delivery outcome. Of 104 women tested, 50 (48.1%) were positive for viral markers. Of these, evidence of infection by DENV, CHIKV, and both was found in 34 (32.7%), 10 (9.6%), and 6 (5.8%), respectively. ZIKV was not detected in any woman. Maximum DENV positivity occurred in the third trimester of pregnancy and in women residing in urban than rural areas. Chills and rigors, arthralgia, retro-orbital pain, anemia, and vaginal bleeding were more commonly associated with DENV positivity. Backache, arthralgia, jaundice, and vaginal bleeding were more common in CHIKV positives but the difference between positives and nonpositives regarding these symptoms was not statistically significant. Dengue infections were associated with more frequent hospitalizations (OR = 8.38, 95% confidence intervals [CI] = 3.29–21.30) and mortality (OR = 19.0, 95% CI = 1.01–357.10). Hence, to conclude, in India wherever possible, all symptomatic pregnant women should be screened for DENV, CHIKV, and ZIKV as part of sentinel surveillance for ZIKV.

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“…6 In a study by Tougma et al on 121 pregnant women infected with DENV, premature birth was reported in about 10% of pregnancies, a similar recent report by Nujum et al reported low birth weight in 18% of cases from a pool of 78 pregnant women infected with DENV. 7,8 The previous meta-analysis by Xiong et al reported no significant association between maternal DENV infection and preterm birth, low birth weight, or miscarriage. 9 However, the result of their analysis was limited to few studies.…”

Section: Introductionmentioning

confidence: 96%

Maternal and foetal‐neonatal outcomes of dengue virus infection during pregnancy

Rathore¹,

Oberoi

Hilliard³

et al. 2022

Tropical Med Int Health

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Objective: Given that women of reproductive age in dengue-endemic areas are at risk of infection, it is necessary to determine whether dengue virus (DENV) infection during pregnancy is associated with adverse outcomes. The aim of this systematic review and meta-analysis is to investigate the consequences of DENV infection in pregnancy on various maternal and foetal-neonatal outcomes. Methods: A systematic literature search was undertaken using PubMed, Google Scholar, and Embase till December 2021. Mantel-Haenszel risk ratios were calculated to report overall effect size using random effect models. The pooled prevalence was computed using the random effect model. All statistical analyses were performed on MedCalc Software. Result: We obtained data from 36 studies involving 39,632 DENV-infected pregnant women. DENV infection in pregnancy was associated with an increased risk of maternal mortality (OR = 4.14 [95% CI, 1.17-14.73]), stillbirth (OR = 2.71 [95% CI, 1.44-5.10]), and neonatal deaths (OR = 3.03 [95% CI, 1.17-7.83]) compared with pregnant women without DENV infection. There was no significant statistical association established between maternal DENV infection and the outcomes of preterm birth, maternal bleeding, low birth weight in neonates, and risk of miscarriage. Pooled prevalences were 14.9% for dengue shock syndrome, 14% for preterm birth, 13.8% for maternal bleeding, 10.1% for low birth weight, 6% for miscarriages, and 5.6% for stillbirth. Conclusion: DENV infection in pregnant women may be associated with adverse outcomes such as maternal mortality, stillbirth, and neonatal mortality. Hence, pregnant women should be considered an at-risk population for dengue management programmes.

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Incidence and outcomes of dengue in a cohort of pregnant women from an endemic region of India: obesity could be a potential risk for adverse outcomes

Cited by 8 publications

References 16 publications

The Seroprevalence of Dengue Virus Infection and Its Association With Iron (Fe) Level in Pregnant Women in Guangzhou, China

The Seroprevalence of Dengue Virus Infection and Its Association With Iron (Fe) Level in Pregnant Women in Guangzhou, China

Prevalence of Dengue, Chikungunya, and Zika Viruses in Febrile Pregnant Women: An Observational Study at a Tertiary Care Hospital in North India

Maternal and foetal‐neonatal outcomes of dengue virus infection during pregnancy

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