Maternal, Fetal, and Neonatal Outcomes in Pregnant Dengue Patients in Mexico

Machaín-Williams, Carlos; Raga, E.; Baak-Baak, Carlos M.; Kiem, Sungmin; Blitvich, Bradley J.; Ramos, Celso

doi:10.1155/2018/9643083

Cited by 30 publications

(33 citation statements)

References 39 publications

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“…In our study, we found that 29% of women with dengue had preterm births and low birthweight infants, which is consistent with recent reviews reporting these factors as the 2 most common adverse pregnancy outcomes (9). Although 9 (21%) infants had head circumferences less than the third percentile, this finding was not associated with maternal dengue infection.…”

Section: Discussionsupporting

confidence: 92%

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Intensified Short Symptom Screening Program for Dengue Infection during Pregnancy, India

Naik

Robinson²,

Alexander³

et al. 2020

Emerg. Infect. Dis.

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E very year, an estimated 96 million persons worldwide are given a clinical diagnosis of severe dengue infection (1). In 2017, a total of 188,401 cases of dengue were diagnosed in India, and the mortality rate was 0.1%. The mortality rate in Maharashtra State was 0.8% in 2017, nearly 8 times higher than the national average (2,3). The prevalence of dengue infection among pregnant women is not reported, but pregnant women may be uniquely susceptible to dengue infection because of the immune changes that occur during pregnancy (4). In some countries in Southeast Asia, dengue fever is the most common cause of acute febrile illness during pregnancy (5). Dengue infection during pregnancy has been associated with poor maternal and infant outcomes, including preterm birth (6), hemorrhage, preeclampsia, and caesarean delivery (7-15). Dengue virus can also be vertically transmitted to the infant, resulting in neonatal dengue, thrombocytopenia, and cerebral hemorrhage (16-19). Vertical transmission is most likely if the infection occurs in the third trimester or is present during delivery by cesarean section (20). Despite the devastating consequences, the diagnosis of dengue infection during pregnancy remains challenging. This challenge is partially caused by overlapping signs and symptoms of dengue infection with other conditions, such as HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, pneumonia, pulmonary embolism, and other febrile illnesses (21,22). Moreover, molecular assays to diagnose dengue are not widely available. However, there is a remarkable reduction in the case-fatality rate after early diagnosis and access to appropriate medical care (23). This study was planned after detection of Zika virus in India. The goal of this study was to determine the prevalence of dengue, chikungunya, and Zika virus among pregnant women in Pune, India. We also aimed to identify clinical predictors of these infections to improve screening and detection during the antenatal setting. Methods Ethics This study was approved by the Byramjee Jeejeebhoy Medical College Clinical Trials Unit and Johns

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Section: Discussionsupporting

confidence: 92%

“…Immunologic changes that occur in mid-to-late pregnancy could lead to an increase in the risk for severe dengue if infections occur during pregnancy (9,36,37). In our study, women were screened mainly during the second and third trimesters because the woman usually come for antenatal care during that period.…”

Section: Discussionmentioning

confidence: 99%

Intensified Short Symptom Screening Program for Dengue Infection during Pregnancy, India

Naik

Robinson²,

Alexander³

et al. 2020

Emerg. Infect. Dis.

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“…Pregnant women face potential complications from infection with either dengue or Zika virus (72). Dengue virus infection might increase the risk for maternal death or obstetric complications (e.g., hemorrhage, preeclampsia, eclampsia, and vertical transmission) during the peripartum period (73)(74)(75). Zika virus infection during pregnancy can result in fetal loss, microcephaly, or serious birth defects including structural abnormalities of the brain and eye (30,72).…”

Section: Clinical and Epidemiologic Criteria For Testingmentioning

confidence: 99%

Dengue and Zika Virus Diagnostic Testing for Patients with a Clinically Compatible Illness and Risk for Infection with Both Viruses

et al. 2019

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Dengue and Zika viruses are closely related mosquitoborne flaviviruses with similar transmission cycles, distribution throughout the tropics and subtropics, and disease manifestations including fever, rash, myalgia, and arthralgia. For patients with suspected dengue or Zika virus disease, nucleic acid amplification tests (NAATs) are the preferred method of diagnosis. Immunoglobulin M (IgM) antibody testing can identify additional infections and remains an important tool for the diagnosis of these diseases, but interpreting the results is complicated by cross-reactivity, and determining the specific timing of infection can be difficult. These limitations are a particular challenge for pregnant women in determining whether Zika virus infection occurred during or before the pregnancy. This report summarizes existing and new guidance on dengue and Zika virus diagnostic testing for patients with a clinically compatible illness who live in or recently traveled to an area where there is risk for infection with both viruses. CDC recommendations for screening of asymptomatic pregnant women with possible Zika virus exposure are unchanged. For symptomatic nonpregnant persons, dengue and Zika virus NAATs should be performed on serum collected ≤7 days after symptom onset. Dengue and Zika virus IgM antibody testing should be performed on NAAT-negative serum specimens or serum collected >7 days after onset of symptoms. For symptomatic pregnant women, serum and urine specimens should be collected as soon as possible within 12 weeks of symptom onset for concurrent dengue and Zika virus NAATs and IgM antibody testing. Positive IgM antibody test results with negative NAAT results should be confirmed by neutralizing antibody tests when clinically or epidemiologically indicated, including for all pregnant women. Data on the epidemiology of viruses known to be circulating at the location of exposure and clinical findings should be considered when deciding which tests to perform and for interpreting results. Patients with clinically suspected dengue should receive appropriate management to monitor and treat shock and hemorrhage. Women with laboratory evidence of possible Zika virus infection during pregnancy and their infants should be evaluated and managed for possible adverse outcomes. Dengue and Zika virus disease are nationally notifiable conditions, and cases should be reported to public health authorities.

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“…Observation in present study was similar to the study by Carlos et al, wherein they reported maternal mortality in 5 cases all had been diagnosed with severe dengue infection, this observation was similar to present study. 17 Old studies report an association between low birth weight babies and dengue infection, with most of LBW attributed to prematurity. [11][12][13] In present study, authors had 4 (11.1%) LBW babies and there were 17 (47.2%) premature babies which was more compared to the aforementioned studies.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of dengue morbidity in pregnancy and its impact on maternal and perinatal outcome

Anuradha¹,

Sandya²,

George³

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Dengue is a vector borne viral infection with seasonal outbreaks every year. The spectrum varies from just a febrile morbidity to the severe form of dengue shock syndrome (DSS). The objective of the present study was to study the influence of dengue fever on pregnancy and to analyze the maternal and perinatal outcome.Methods: Thirty-six pregnant women beyond 28weeks of gestation who tested positive for dengue infection were retrospectively analyzed during a 5year study period (Jan 2014-Dec 2018). The study was conducted in the Department of OBGYN St John’s Medical College Hospital, Bangalore. Thirty-three of these patients delivered at St John’s and there were three postpartum referral cases. The necessary data was obtained by patient record review. The data was analyzed using SPSS and the results were expressed as Mean±SD and percentages.Results: Out of 36 women analyzed the mean age was found to be 23.93±4.5 years. Majority were primigravidae (58.3%). The most common clinical manifestation was fever seen in 47.2%. Twenty five percent of patients had platelet count of <20,000 on admission. Overall 66% of the patients required transfusion. Nearly fifty three percent of the patients had vaginal delivery. There were 4 maternal mortalities (11.1%) and 2 perinatal mortalities (5.5%) both were still births in the present study.Conclusions: Dengue infection in pregnancy was associated with increased maternal and perinatal morbidity as well as mortality. The severity of the infection has direct impact on the outcome. Hence early diagnosis and prompt management in a tertiary care centre, with multidisciplinary approach improves the outcome and minimizes the complications.

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Maternal, Fetal, and Neonatal Outcomes in Pregnant Dengue Patients in Mexico

Cited by 30 publications

References 39 publications

Intensified Short Symptom Screening Program for Dengue Infection during Pregnancy, India

Intensified Short Symptom Screening Program for Dengue Infection during Pregnancy, India

Dengue and Zika Virus Diagnostic Testing for Patients with a Clinically Compatible Illness and Risk for Infection with Both Viruses

Spectrum of dengue morbidity in pregnancy and its impact on maternal and perinatal outcome

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