Maternal and Fetal Outcome of Dengue Fever in Pregnancy: A Cross-Sectional Study
Article Sidebar
Main Article Content
Abstract
Background: Dengue fever, a mosquito-borne viral infection, has become a significant global health concern, particularly in tropical and subtropical regions. The impact of dengue fever on pregnancy outcomes is a growing area of concern, with potential risks for both maternal and fetal health.
Objective: To assess the maternal and fetal outcomes of dengue fever in pregnancy.
Methods: This cross-sectional study was conducted at Hajiani Hospital and Bilawal Medical College Teaching (CDF) Hospital in Hyderabad over two years from January 1, 2020, to December 31, 2021. During this period, 2490 obstetric patients were admitted, and 52 of them, diagnosed with dengue fever during pregnancy, were included in the study. Data collection involved comprehensive medical histories, physical examinations, and routine laboratory tests, including rapid antigen and antibody tests for dengue, liver and renal function tests, and viral serology for hepatitis B and C. Descriptive statistics were calculated using SPSS version 25, including frequencies, percentages, means, and standard deviations.
Results: Out of the 52 patients with dengue fever in pregnancy, the mean age was 29.04 ± 8.40 years. A significant majority (94.2%) had not received antenatal care, and most were from rural areas (71.15%) and illiterate (78.84%). The mean duration of hospital stay was 4.57 ± 2.932 days. Common symptoms included fever (88.4%), gum bleeding (71.1%), and vomiting (53.8%). Major complications were thrombocytopenia (90.3%), obstetric hemorrhage (71.1%), and anemia (71.1%). Maternal mortality was 13.4%. Among the 37 patients who delivered, 45.9% had vaginal deliveries, 32% required instrumental delivery, and 21.6% underwent cesarean sections. Miscarriage occurred in 13.51% of the deliveries, preterm delivery in 37.87%, stillbirth in 2.70%, and neonatal mortality in 16.2%.
Conclusion: Acute dengue fever in pregnancy poses a significant clinical challenge with high maternal and fetal morbidity and mortality. The symptomatic dengue fever is associated with increased risks of miscarriage, preterm delivery, and poor neonatal outcomes. Enhanced antenatal care and early detection are crucial in managing these risks.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Narvaez F, Gutierrez G, Pérez MA, Elizondo D, Nuñez A, Balmaseda A, et al. Evaluation of the Traditional and Revised WHO Classifications of Dengue Disease Severity. PLoS Negl Trop Dis. 2011;5
Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, et al. Dengue: A Continuing Global Threat. Nat Rev Microbiol. 2010;8
Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, et al. The Global Distribution and Burden of Dengue. Nature. 2013;496:504–507.
Goh KT. Changing Epidemiology of Dengue in Singapore. Lancet. 1995;346:1098.
World Health Organization. Dengue Hemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization; 1997.
Balmaseda A, Hammond SN, Pérez MA, Cuadra R, Solano S, Rocha J, et al. Assessment of the World Health Organization Scheme for Classification of Dengue Severity in Nicaragua. Am J Trop Med Hyg. 2005;73(6):1059–1062.
Phuong CX, Nhan NT, Kneen R, Thuy PT, Ha NT, Thien HV, et al. Clinical Diagnosis and Assessment of Severity of Confirmed Dengue Infections in Vietnamese Children: Is the World Health Organization Classification System Helpful? Am J Trop Med Hyg. 2004;70(2):172–179.
World Health Organization. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization; 2009.
Paixão ES, Teixeira MG, Costa MDCN, Rodrigues LC. Dengue During Pregnancy and Adverse Fetal Outcomes: A Systematic Review and Meta-Analysis. Lancet Infect Dis. 2016;16(7):857–865.
Pouliot SH, Xiong X, Harville E, Paz-Soldan V, Tomashek KM, Breart G, et al. Maternal Dengue and Pregnancy Outcomes: A Systematic Review. Obstet Gynecol Surv. 2010;65(2):107–118.
Machado CR, Machado ES, Rohloff RD, Azevedo M, Campos DP, Oliveira RB, et al. Is Pregnancy Associated with Severe Dengue? A Review of Data from the Rio de Janeiro Surveillance Information System. PLoS Negl Trop Dis. 2013;7
Feitoza HAC, Koifman S, Koifman RJ, Saraceni V. Dengue Infection During Pregnancy and Adverse Maternal, Fetal, and Infant Health Outcomes in Rio Branco, Acre State, Brazil, 2007-2012. Cad Saude Publica. 2017;33
Carles G, Peiffer H, Talarmin A. Effects of Dengue Fever During Pregnancy in French Guiana. Clin Infect Dis. 1999;28:637–640.
Paixão ES, Teixeira MG, da Conceição NCM, Rodrigues LC. Dengue During Pregnancy and Adverse Fetal Outcomes: A Systematic Review and Meta-Analysis. Lancet Infect Dis. 2016;16:857–865.
Sirinavin S, Nuntnarumit P, Supapannachart S, Boonkasidecha S, Techasaensiri C, Yoksarn S. Vertical Dengue Infection: Case Reports and Review. Pediatr Infect Dis J. 2004;23:1042–1047.
Carles G. What Are the True Consequences of Dengue During Pregnancy? Lancet Infect Dis. 2016;16:765–766.
Brar R, Sikka P, Suri V, Singh MP, Suri V, Mohindra R, Biswal M. Maternal and Fetal Outcomes of Dengue Fever in Pregnancy: A Large Prospective and Descriptive Observational Study. Arch Gynecol Obstet. 2021;304(1):91–100.
Veena L. Dengue Infection in Pregnancy and Outcome in a Tertiary Care Centre. Int J Reprod Contracept Obstet Gynecol. 2018;7(12):5051–5056.
Hcini N, Maamri F, Picone O, Carod JF, Lambert V, Mathieu M, Carles G, Pomar L. Maternal, Fetal and Neonatal Outcomes of Large Series of SARS-CoV-2 Positive Pregnancies in Peripartum Period: A Single-Center Prospective Comparative Study. Eur J Obstet Gynecol Reprod Biol. 2021;257:11–18.
Nguyen TM, Huan VT, Reda A, Morsy S, Giang HT, Tri VD, Mau NK, Elfaituri MK, Hieu TH, Hung NT, Hirayama K. Clinical Features and Outcomes of Neonatal Dengue at the Children’s Hospital 1, Ho Chi Minh, Vietnam. J Clin Virol. 2021;138:104758.
Shoaib M, Tareen MS, Afridi U, Saifullah S. Maternal and Neonatal Outcomes in Pregnant Women with Dengue. P J M H S. 2021;15(11):3161.