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Rathore SS, Oberoi S, Hilliard J, Raja R, Ahmed NK, Vishwakarma Y, Iqbal K, Kumari C, Velasquez-Botero F, Nieto-Salazar MA, Cortes GAM, Akomaning E, Musa IEM. Maternal and foetal-neonatal outcomes of dengue virus infection during pregnancy. Trop Med Int Health 2022; 27:619-629. [PMID: 35689528 DOI: 10.1111/tmi.13783] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
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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Affiliation(s)
- Sawai Singh Rathore
- Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India
| | - Sharvi Oberoi
- Internal Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
| | - Jonathan Hilliard
- College of Medicine, All Saints University College of Medicine, Amos Vale, Saint Vincent and the Grenadines
| | - Ritesh Raja
- Internal Medicine, China Three Georges University, Yichang, Hubei Province, China
| | | | - Yogesh Vishwakarma
- Internal Medicine, American University of Barbados, Wildey, St. Michael, Barbados
| | - Kinza Iqbal
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Chandani Kumari
- Internal Medicine, American University of Barbados, Wildey, St. Michael, Barbados
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de Mel S, Thilakawardana BU, de Mel P, Clarice CSH, Shalindi M, de Mel C, Chandrasena L, Yip C, Yap ES, Seneviratne SL, Abeysuriya V. Triple positivity for nonstructural antigen 1, immunoglobulin M and immunoglobulin G is predictive of severe thrombocytopaenia related to dengue infection. J Clin Virol 2020; 129:104509. [PMID: 32554305 DOI: 10.1016/j.jcv.2020.104509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The early identification of patients at risk of severe dengue infection (DI) is critical to guide clinical management. Non-structural antigen 1 (NS-1), immunoglobulin M (IgM) and immunoglobulin G (IgG) are used routinely for the diagnosis of DI. OBJECTIVES We sought to evaluate whether positivity for NS-1, IgM and IgG individually or together is predictive of severe complications of DI. METHODS & MATERIALS A prospective study was conducted among patients with DI admitted to our institution between 2014 and 2019. DI was diagnosed based on a positive NS1 or IgM. IgG was also tested on all the patients. Clinical data was obtained from electronic medical records at NH. Statistical analyses were performed using SPSS version 20. RESULTS We collected data on 3504 patients. Patients who were positive for NS1, IgM and IgG (triple positive: TP) were more likely to develop severe DI (63.8 %) in comparison to those who were only NS1 positive (single positive: SP) (3.0 %) and patients with positive NS1 and IgM (double positive: DP) (7.5 %). [p = 0.001]. Regression analysis confirmed that TP status on admission was predictive of severe complications. (p < 0.01). Receiver operator characteristic curve (ROC) analysis showed (AUC: 84.8; sensitivity = 90.7 and specificity = 83.2) that TP status on admission is predictive of thrombocytopenia on day 5. The predictive power of TP status was superior to that of NS1 and IgG positivity. CONCLUSIONS We propose that TP status on admission is a novel predictive factor for severe DI. Further studies are required to explore the biological basis for this finding.
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Affiliation(s)
- Sanjay de Mel
- Department of Haematology- Oncology, National University Cancer Institute, National University Health System, Singapore
| | | | - Primesh de Mel
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - Choong Shi Hui Clarice
- Department of Haematology- Oncology, National University Cancer Institute, National University Health System, Singapore
| | - Malka Shalindi
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - Chandima de Mel
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - Lal Chandrasena
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - Christina Yip
- Department of Laboratory Medicine, National University Health System, Singapore
| | - Eng-Soo Yap
- Department of Laboratory Medicine, National University Health System, Singapore
| | - Suranjith L Seneviratne
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka; Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka; Institute of Immunity and Transplantation, Royal Free Hospital and University College London, UK
| | - Visula Abeysuriya
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka.
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Mulyana RS, Pangkahila ES, Pemayun TGA. Maternal and Neonatal Outcomes during Dengue Infection Outbreak at a Tertiary National Hospital in Endemic Area of Indonesia. Korean J Fam Med 2020; 41:161-166. [PMID: 32311872 PMCID: PMC7272366 DOI: 10.4082/kjfm.18.0154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 12/04/2018] [Indexed: 11/30/2022] Open
Abstract
Background Dengue infection is the most common mosquito-borne disease in Indonesia. Dengue incidence during pregnancy increases with its prevalence among women of reproductive ages. It potentially causes serious maternal and neonatal morbidity and mortality; however, its impact during a period of disease outbreak has not been described. We aimed to assess the outcomes of pregnancies affected by dengue infection during an outbreak in an endemic area of Indonesia. Methods We conducted a prospective observational study at Sanglah General Hospital, Bali, Indonesia from April 2016 to April 2017. All pregnant women with clinical symptoms of dengue infection who tested positive for dengue nonstructural protein 1-antigen or anti-dengue immunoglobulin M were included in the study. Clinical features and hematological and biochemical parameters were documented to assess their relationship with maternal and neonatal outcomes. Results Our study population consisted of 41 pregnant women. Most were multigravida (58.5%). Dengue infection without warning signs was observed in 31.7% of the cases, while 53.7% had dengue infection with warning signs, and 14.6% had dengue shock syndrome/severe dengue infection. Most pregnancies were in the third trimester (78%); five cases (12.2%) suffered clinical complications. Preterm delivery was observed in seven cases (17.1%). Most patients (75.6%) decided to seek medical treatment at a critical phase of dengue infection (days 3–6). Conclusion The high incidence of associated morbidity and mortality should warrant clinicians in endemic regions to consider diagnoses of dengue infection when treating pregnant women with clinical signs and symptoms. Patients should be treated at centers with adequate resources for monitoring and emergency procedures. A more intensive study is needed in the future aiming to make a more comprehensive guideline.
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Affiliation(s)
- Ryan Saktika Mulyana
- Maternal-Fetal Medicine Division, Obstetrics and Gynecology Department, Udayana University and Sanglah Hospital, Denpasar, Indonesia
| | - Evert Solomon Pangkahila
- Maternal-Fetal Medicine Division, Obstetrics and Gynecology Department, Udayana University and Sanglah Hospital, Denpasar, Indonesia
| | - Tjokorda Gede Astawa Pemayun
- Obstetrics and Gynecology Residency, Obstetrics and Gynecology Department, Udayana University and Sanglah Hospital, Denpasar, Indonesia
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Naik S, Robinson ML, Alexander M, Chandanwale A, Sambarey P, Kinikar A, Bharadwaj R, Sapkal GN, Chebrolu P, Deshpande P, Kulkarni V, Nimkar S, Mave V, Gupta A, Mathad J. Intensified Short Symptom Screening Program for Dengue Infection during Pregnancy, India. Emerg Infect Dis 2020; 26:738-743. [PMID: 32186485 PMCID: PMC7101120 DOI: 10.3201/eid2604.191476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Mosquitoborne diseases (e.g., malaria, dengue, and chikungunya) are endemic to India and pose diagnostic challenges during pregnancy. We evaluated an intensified short symptom screening program in India to diagnose dengue during pregnancy. During October 2017–January 2018, we screened pregnant women during antenatal surveillance for symptoms of mosquitoborne diseases (fever only, fever with conjunctivitis, fever with rash, or all 3 symptoms) within the previous 15 days. Of 5,843 pregnant women screened, 52 were enrolled and tested for dengue, chikungunya, and Zika viruses by using a Trioplex real-time reverse transcription PCR. Of 49 who had complete results, 7 (14%) were dengue positive. Of these ocular pain was seen in 4 (57%) and conjunctivitis in 7 (100%). Intensified symptom screening using conjunctivitis, in addition to rash, in pregnant women with fever might improve dengue case detection and can be included in routine symptom screening during pregnancy.
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Sondo KA, Ouattara A, Diendéré EA, Diallo I, Zoungrana J, Zémané G, Da L, Gnamou A, Meda B, Poda A, Zamané H, Ouédraogo A, Ouédraogo M, Thieba/Bonané B. Dengue infection during pregnancy in Burkina Faso: a cross-sectional study. BMC Infect Dis 2019; 19:997. [PMID: 31771564 PMCID: PMC6880640 DOI: 10.1186/s12879-019-4587-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 10/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dengue fever is prevalent in the world; in recent years, several outbreaks occurred in West Africa. It affects pregnant women. We aimed to assess the consequences of dengue fever on pregnant women and their fetuses during dengue epidemic in Burkina Faso. METHODS We conducted a cross-sectional study from November 1, 2015 to January 31, 2017 in 15 public and private health facilities in Ouagadougou, using secondary data. Immunochromatographic rapid test Duo detecting specific antibodies, immunoglobin M/G and /or dengue non structural antigen1 virus was used to diagnose dengue cases. RESULTS Out of 399 (48%) women registered during the study period, 25 (6%) were pregnant. The average age of pregnant women was 30 years, with 18 and 45 years as extremes. The main symptoms were fever (92%) and headache (92%). Nine patients (36%) had severe dengue characterized by bleeding (16%), neurological symptoms (16%) and acute respiratory distress (8%). Eight (32%) of the 25 women had early miscarriage and 8 (32%) women gave birth to viable fetuses. Among those with viable babies, 5 (20%) presented post-partum hemorrhage and 3 (12%) presented early delivery. The main fetal complications included 3 cases of acute fetal distress (12%). One case of maternal death (4%) and 4 cases of neonatal mortality (44.5%) were notified. CONCLUSION Dengue fever occurring during pregnancy increases maternal and neonatal mortality. Its severe complications require specific monitoring of pregnant women until delivery.
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Affiliation(s)
- Kongnimissom Apoline Sondo
- Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso.
- Department of Infectious Diseases (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso.
| | - Adama Ouattara
- Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
- Obstetrics and Gynecology Departement (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
| | - Eric Arnaud Diendéré
- Department of Infectious Diseases (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
| | - Ismaèl Diallo
- Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
| | - Jacques Zoungrana
- Higher Health Science Institute, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Guelilou Zémané
- Department of Infectious Diseases (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
| | - Léa Da
- Department of Infectious Diseases (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
| | - Arouna Gnamou
- Department of Infectious Diseases (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
| | - Bertrand Meda
- Health Science Research Institute of Ouagadougou (Biomedical department), Ouagadougou, Burkina Faso
| | - Armel Poda
- Higher Health Science Institute, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Hyacinthe Zamané
- Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
- Obstetrics and Gynecology Departement (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
| | - Ali Ouédraogo
- Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
- Obstetrics and Gynecology Departement (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
| | - Macaire Ouédraogo
- Higher Health Science Institute, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Blandine Thieba/Bonané
- Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
- Obstetrics and Gynecology Departement (Yalgado Ouedraogo Teaching Hospital), Ouagadougou, Burkina Faso
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Abstract
Dengue infection during pregnancy carries the risk of vertical transmission to the fetus and newborn. This is higher if the infection occurs late in pregnancy and the mother delivers at the height of viremia. In such a scenario, both mother and neonate are at risk of life-threatening complications. We present an interesting case of dengue infection in a preterm neonate managed at our unit.
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Affiliation(s)
- Jenisha Jain
- Department of Neonatology, Mehta Multispeciality Hospitals India Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Lakshmi V
- Department of Neonatology, Mehta Multispeciality Hospitals India Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Shanmughsundaram R
- Department of Neonatology, Mehta Multispeciality Hospitals India Pvt. Ltd., Chennai, Tamil Nadu, India
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Basurko C, Everhard S, Matheus S, Restrepo M, Hildéral H, Lambert V, Boukhari R, Duvernois JP, Favre A, Valmy L, Nacher M, Carles G. A prospective matched study on symptomatic dengue in pregnancy. PLoS One 2018; 13:e0202005. [PMID: 30281605 PMCID: PMC6169853 DOI: 10.1371/journal.pone.0202005] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 07/26/2018] [Indexed: 11/18/2022] Open
Abstract
Dengue fever is an increasing problem worldwide, but consequences during pregnancy remain unclear. Much of the available literature suffers from methodological biases that compromise the validity of clinical recommendations. We conducted a matched cohort study during an epidemic in French Guiana to compare events and pregnancy outcomes between two paired groups of pregnant women: women having presented with symptomatic dengue during pregnancy (n = 73) and women having had neither fever nor dengue during pregnancy (n = 219). Women in each arm were matched by place of follow up, gestation weeks at inclusion, and place of residence. Dengue infection was considered to be confirmed if viral RNA, N S1 antigen, the seroconversion of IgM antibodies or the presence of IgM was detected in collected samples. According to the 2009 WHO classification, 27% of the women with symptomatic dengue had at least one clinical or biological warning sign. These complications occurred after the 28th week of gestation in 55% of cases. The medical history, socioeconomic status and demographic characteristics were included in multivariate analysis. Exposure to dengue during pregnancy was not significantly associated with prematurity, small for gestational age infants, hypertension or emergency caesarian section. Maternal dengue with warning signs was a risk factor for peripartum hemorrhage with adjusted relative risk = 8.6(95% CI = 1.2–62). There was a near significant association between dengue and in utero death (p = 0.09). This prospective comparative study underlined the importance of taking into account potential confounders between exposure to dengue and the occurrence of obstetrical events. It also confirms the need for increased vigilance for pregnant women with dengue, particularly for women who present with severe dengue.
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Affiliation(s)
- Célia Basurko
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France
- Equipe EA3593, Ecosystèmes amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana, France
- * E-mail: (CB); (MN)
| | - Sibille Everhard
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France
| | - Séverine Matheus
- Laboratoire de virologie, Centre National de Référence des Arbovirus, Institut Pasteur de la Guyane Cayenne, French Guiana, France
| | - Marion Restrepo
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France
- Service de gynécologie et d'obstétrique, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France
- Pôle de santé publique, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France
| | - Hélène Hildéral
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France
| | - Véronique Lambert
- Service de gynécologie et d'obstétrique, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France
| | - Rachida Boukhari
- Service d'analyses médicales, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France
| | - Jean-Pierre Duvernois
- Service de gynécologie et d'obstétrique, Centre médico-chirurgical de Kourou, Croix Rouge Française, Kourou, French Guiana, France
| | - Anne Favre
- Réseau périnat de Guyane, Cayenne, French Guiana, France
| | - Larissa Valmy
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France
- Equipe EA3593, Ecosystèmes amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana, France
- * E-mail: (CB); (MN)
| | - Gabriel Carles
- Service de gynécologie et d'obstétrique, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France
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Iannetta M, Lalle E, Musso M, Carletti F, Scorzolini L, D'Abramo A, Chinello P, Castilletti C, Ippolito G, Capobianchi MR, Nicastri E. Persistent detection of dengue virus RNA in vaginal secretion of a woman returning from Sri Lanka to Italy, April 2017. ACTA ACUST UNITED AC 2018; 22. [PMID: 28857045 PMCID: PMC5753441 DOI: 10.2807/1560-7917.es.2017.22.34.30600] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 08/23/2017] [Indexed: 11/20/2022]
Abstract
We describe the dynamics of dengue virus (DENV) infection in a woman in her mid-30s who developed fever after returning from Sri Lanka to Italy in April 2017. Laboratory testing demonstrated detectable DENV-RNA in plasma, urine, saliva, vaginal secretion. Persistent shedding of DENV-RNA was demonstrated in vaginal secretion, and DENV-RNA was detectable in the pelleted fraction up to 18 days from symptom onset. These findings give new insights into DENV vaginal shedding and vertical transmission.
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Affiliation(s)
- Marco Iannetta
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Eleonora Lalle
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Maria Musso
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Fabrizio Carletti
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Laura Scorzolini
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Alessandra D'Abramo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Pierangelo Chinello
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Concetta Castilletti
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Maria R Capobianchi
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - Emanuele Nicastri
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
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Machain-Williams C, Raga E, Baak-Baak CM, Kiem S, Blitvich BJ, Ramos C. Maternal, Fetal, and Neonatal Outcomes in Pregnant Dengue Patients in Mexico. Biomed Res Int 2018; 2018:9643083. [PMID: 29607328 DOI: 10.1155/2018/9643083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/02/2017] [Accepted: 11/12/2017] [Indexed: 01/25/2023]
Abstract
To increase our understanding of the consequences of dengue virus infection during pregnancy, a retrospective analysis was performed on the medical records of all completed pregnancies (live births and pregnancy losses) at nine public hospitals in the Gulf of Mexico from January to October 2013. Eighty-two patients developed clinical, laboratory-confirmed dengue virus infections while pregnant. Of these, 54 (65.9%) patients were diagnosed with dengue without warning signs, 15 (18.3%) patients were diagnosed with dengue with warning signs, and 13 (15.9%) patients had severe dengue. Five (38.5%) patients with severe dengue experienced fetal distress and underwent emergency cesarean sections. Four patients delivered apparently healthy infants of normal birthweight while the remaining patient delivered a premature infant of low birthweight. Patients died of multiple organ failure during or within 10 days of the procedure. Severe dengue was also associated with obstetric hemorrhage (30.8%, four cases), preeclampsia (15.4%, two cases), and eclampsia (7.7%, one case). These complications were less common or absent in patients in the other two disease categories. Additionally, nonsevere dengue was not associated with maternal mortality, fetal distress, or adverse neonatal outcomes. In summary, the study provides evidence that severe dengue during pregnancy is associated with a high rate of fetal distress, cesarean delivery, and maternal mortality.
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Affiliation(s)
- Ritesh Panchal
- School of Science, SVKM’s Narsee Monjee Institute of Management Studies, VLMetha Road, Vile Parle (W), Mumbai 400 056, Maharashtra, India
| | - S. Mukerjee
- Haffkine Institute for Training, Research& Testing, Acharya Donde Marg, Parel Mumbai 400 012, Maharashtra, India
| | - Abay Chowdhary
- Haffkine Institute for Training, Research& Testing, Acharya Donde Marg, Parel Mumbai 400 012, Maharashtra, India
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11
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Xiong Y, Mo Y, Shi T, Zhu L, Chen Q. Dengue virus infection during pregnancy increased the risk of adverse fetal outcomes? An updated meta-analysis. J Clin Virol 2017; 94:42-9. [DOI: 10.1016/j.jcv.2017.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 01/11/2023]
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12
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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:e00178915. [PMID: 28614453 DOI: 10.1590/0102-311x00178915] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 06/24/2016] [Indexed: 11/22/2022] Open
Abstract
The effects of dengue infection during pregnancy have not been previously studied in Rio Branco, Acre State, Brazil. The aim of this study was to determine the risks of maternal, fetal, and infant complications resulting from dengue infection during pregnancy. The study compared two cohorts of pregnant women, exposed versus unexposed to dengue virus, from 2007 to 2012. Incidence rates and risk ratios were estimated for maternal, fetal, and infant complications. In the exposed cohort there were 3 fetal deaths and 5 neonatal deaths. Two maternal deaths were identified in the exposed cohort, as opposed to none in the unexposed group (p = 0.040). The exposed cohort showed a risk ratio (RR) of 3.4 (95%CI: 1.02-11.23) for neonatal death. The risk ratio for early neonatal death was 6.8 (95%CI: 1.61-28.75). Ten infant deaths occurred in children of exposed pregnant women and 7 in unexposed (RR = 6.0; 95%CI: 2.24-15.87). Women infected with dengue virus in pregnancy showed increased risk ratio for maternal, neonatal, and infant mortality.
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Affiliation(s)
| | | | - Rosalina Jorge Koifman
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Valéria Saraceni
- Superintendência de Vigilância em Saúde, Secretaria Municipal de Saúde, Rio de Janeiro, Brasil† Falecido
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Zavattoni M, Rovida F, Campanini G, Percivalle E, Sarasini A, Cristini G, Tomasoni LR, Castelli F, Baldanti F. Miscarriage following dengue virus 3 infection in the first six weeks of pregnancy of a dengue virus-naive traveller returning from Bali to Italy, April 2016. ACTA ACUST UNITED AC 2017; 21:30308. [PMID: 27526349 PMCID: PMC4998508 DOI: 10.2807/1560-7917.es.2016.21.31.30308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 08/03/2016] [Indexed: 12/16/2022]
Abstract
We report miscarriage following dengue virus (DENV)-3 infection in a pregnant woman returning from Bali to Italy in April 2016. On her arrival, the woman had fever, rash, asthenia and headache. DENV RNA was detected in plasma and urine samples collected the following day. Six days after symptom onset, she had a miscarriage. DENV RNA was detected in fetal material, but in utero fetal infection cannot be demonstrated due to possible contamination by maternal blood.
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Affiliation(s)
- Maurizio Zavattoni
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Yin X, Zhong X, Pan S. VERTICAL TRANSMISSION OF DENGUE INFECTION: THE FIRST PUTATIVE CASE REPORTED IN CHINA. Rev Inst Med Trop Sao Paulo 2016; 58:90. [PMID: 27982356 PMCID: PMC5147720 DOI: 10.1590/s1678-9946201658090] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 07/25/2016] [Indexed: 11/22/2022] Open
Abstract
Dengue is a systemic viral infection that is commonly transmitted between humans via
mosquitoes. Other modes of transmission such as the vertical one are rare and have
been infrequently reported in the literature. This report investigates one case of
vertical transmission of dengue in Guangzhou, China. A G1P1 lady at 39 weeks of
gestation was referred to the Huzhong Hospital presenting a fever for two days. She
subsequently developed a skin rash on the back and lower limb and at that time she
had already experienced five days of fever. She subsequently went into labor and
delivered a female neonate weighting 3,500 g at birth. The neonate developed fever on
the third day of life which was associated with a systemic erythematous skin rash.
There was no report or evidence of mosquito bites after birth. A complete blood count
showed leucopenia, thrombocytopenia and anemia and the liver function test showed
elevated AST, GGT and bilirubin. Dengue was diagnosed in the mother and the neonate
by the ELISA dengue virus NS1 antigen test (Wantai, Beijing, China) and dengue virus
fluorogenic quantitative PCR test (Liferiver, Shanghai, China).The case report
illustrates the possibility of the vertical transmission of dengue. Clinicians should
be alert to this possibility and institute early treatment. Further direct evidence
and research are required.
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Affiliation(s)
- Xueru Yin
- Southern Medical University, Guangzhou 510515, People's Republic of China. E-mail:
| | - Xiaozhu Zhong
- Department of Infectious Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, People's Republic of China. E-mail:
| | - Shilei Pan
- Department of Obstetrics and Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, People's Republic of China. E-mail:
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Paixão ES, Teixeira MG, Costa MDCN, Rodrigues LC. Dengue during pregnancy and adverse fetal outcomes: a systematic review and meta-analysis. The Lancet Infectious Diseases 2016; 16:857-865. [DOI: 10.1016/s1473-3099(16)00088-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 10/22/2022]
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Ramly F, Suhaila S, Gugan S, Rahman AMA. Mode of Delivery for Peripartum Dengue (Critical Phase): Two Case Reports. Journal of South Asian Federation of Obstetrics and Gynaecology 2016; 8:163-165. [DOI: 10.5005/jp-journals-10006-1409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
ABSTRACT
Background
Dengue is an important notifiable disease in tropical countries. Widespread capillary leakage poses big challenges in managing obstetrics population affected by dengue. Managing delivery during peripartum especially at a critical dengue phase is scarcely reported. We reported two peripartum dengue cases with two different modes of delivery.
Conclusion
Dengue in peripartum period is best managed by multidisciplinary input, particularly infectious disease experts and close monitoring involving ICU. Both modes of delivery are possible given that strict monitoring and mother optimization are put at prime.
How to cite this article
Ramly F, Suhaila S, Gugan S, Rahman AMA. Mode of Delivery for Peripartum Dengue (Critical Phase): Two Case Reports. J South Asian Feder Obst Gynae 2016;8(2):163-165.
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Abstract
As the incidence of dengue is rising among adults more cases of dengue fever are being reported during pregnancy. Physiological changes of pregnancy mask the pathognomonic features of severe dengue such as increased hematocrit, thrombocytopenia, and leukopenia and a high index of suspicion are required in endemic areas. Massive hemorrhage may complicate operative deliveries in unsuspected patients. World Health Organization recommends that all patients with severe dengue should be admitted to a hospital with access to intensive care facilities and blood transfusion. We present the successful management of hemorrhage and unanticipated complications of severe dengue in a young primigravida admitted to the Intensive Care Unit after an emergency cesarean section.
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Affiliation(s)
- Madiha Hashmi
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
| | - Ghulam Zainab
- Department of Gynaecology and Obstetrics, Aga Khan University, Karachi, Pakistan
| | - Farah Khan
- Department of Gynaecology and Obstetrics, Aga Khan University, Karachi, Pakistan
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Affiliation(s)
- Alpana Singh
- Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Shilpa Singh
- Senior Resident, Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Gita Radhakrishnan
- Director Professor and Head, Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - A G Radhika
- Specialist, Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Richa Sharma
- Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Mohamed Ismail NA, Wan Abd Rahim WE, Salleh SA, Neoh HM, Jamal R, Jamil MA. Seropositivity of dengue antibodies during pregnancy. ScientificWorldJournal 2014; 2014:436975. [PMID: 25587564 DOI: 10.1155/2014/436975] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/11/2014] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Malaysia a dengue endemic country with dengue infections in pregnancy on the rise. The present study was aimed at determining dengue seroprevalence (IgG or IgM) during pregnancy and its neonatal transmission in dengue seropositive women. METHODS Maternal with paired cord blood samples were tested for dengue antibodies (IgG and IgM) using an enzyme-linked immunosorbent assay (ELISA). Maternal age, parity, occupation, ethnic group, and gestational age were recorded. Data on neonatal Apgar score and admissions to the Neonatal Intensive Care Unit (NICU) were analyzed. RESULTS Out of 358 women recruited, about 128 (35.8%) patients were seropositive. Twelve patients (3.4%) had recent infections (IgM positive) and another 116 women (32.4%) were with past infections (IgG positive). All babies born to seropositive mothers had positive IgG paired cord blood; however, no IgM seropositivity was observed. All neonates had good Apgar scores and did not require NICU admission. CONCLUSION In this study, 35.8% pregnant women were found to be dengue seropositive. However, transplacental transfer of IgG antibodies had no detrimental effect on the neonatal outcomes.
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Abstract
BACKGROUND Dengue in pregnancy is associated with many maternal and foetal outcomes including perinatal transmission of dengue infection. CASE PRESENTATION A baby was born by emergency caesarean section due to foetal distress and meconium stained liquor, to a 27-year old primi-gravidae, Sinhalese female, who was febrile during and 2 days prior to labour. The baby had evidence of respiratory distress due to meconium aspiration and was cared for in the special care baby unit for 3 days. On the 4th day he developed fever and serial blood counts showed a gradual rise in the haematocrit (>20% of baseline value) and lowering of platelet counts. The baby was treated for sepsis and as Sri Lanka was experiencing a massive dengue epidemic was also tested for dengue. His dengue NS1 antigen test was strongly positive and the dengue IgM antibodies weakly positive on day 3 of illness. The mother was positive for both dengue IgM and IgG antibodies. CONCLUSION Although rare, vertical transmission of the dengue virus has been reported and the baby most likely developed dengue due to perinatal transmission of dengue.
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Affiliation(s)
| | | | - Gathsaurie Neelika Malavige
- Centre for Dengue Research, Faculty of Medical Sciences, University of Sri Jayawardanapura, Nugegoda, Sri Lanka.
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Mazarin N, Rosenthal J, Devenge J. Dengue materno-fœtale au cours de l’épidémie de 2009–2010 en Guadeloupe : à propos de 4 cas. Arch Pediatr 2014; 21:745-9. [DOI: 10.1016/j.arcped.2014.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/09/2013] [Accepted: 04/16/2014] [Indexed: 11/19/2022]
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Gasim GI, Adam I. Severe dengue and pregnancy: a review of data from the Rio de Janeiro, Brazil, surveillance information system. Future Virol 2013. [DOI: 10.2217/fvl.13.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Evaluation of: Machado CR, Machado ES, Rohloff RD et al. Is pregnancy associated with severe dengue? A review of data from the Rio de Janeiro surveillance information system. PLoS Negl. Trop. Dis. 7(5), e2217 (2013). Dengue is the most common mosquito-borne infection. Owing to many factors (including urbanization and travel), dengue is now spreading in many settings in the world where it was not previously endemic. In most cases, dengue infections are asymptomatic or a mild form of the disease, while severe dengue cases are rarely reported. Few reports are available on dengue during pregnancy, and such infections can lead to miscarriage, preterm delivery, fetal death, low birth weight, neonatal admissions to the intensive care unit, fetal anomalies and maternal mortality.
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Affiliation(s)
- Gasim I Gasim
- College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics & Gynecology, Medicine, University of Khartoum, Khartoum, Sudan
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Mota AKMD, Miranda Filho AL, Saraceni V, Koifman S. [Maternal mortality and impact of dengue in Southeast Brazil: an ecological study, 2001-2005]. CAD SAUDE PUBLICA 2012; 28:1057-66. [PMID: 22666810 DOI: 10.1590/s0102-311x2012000600005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 03/15/2012] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to explore the distribution of reproductive outcomes following dengue virus infection during pregnancy (2001-2005). An ecological epidemiological study was conducted in all counties with more than 80,000 inhabitants in Southeast Brazil. The study explored the correlation between dengue incidence rates in women 15-39 years of age and selected mortality indicators (maternal, fetal, perinatal, neonatal, early neonatal, and infant) in these counties, and Spearman correlation coefficients were calculated. A positive correlation was observed between median dengue incidence in women 15-39 years of age and median maternal mortality (r = 0.88; 95%CI: 0.51; 1.00), with a determination coefficient R² = 0.78. The correlation between dengue incidence in childbearing-age women and reproductive outcomes in Southeast Brazil suggests that dengue infection during pregnancy can negatively impact its outcome and increase maternal mortality.
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Tan PC, Soe MZ, Si Lay K, Wang SM, Sekaran SD, Omar SZ. Dengue infection and miscarriage: a prospective case control study. PLoS Negl Trop Dis 2012; 6:e1637. [PMID: 22590658 DOI: 10.1371/journal.pntd.0001637] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 03/23/2012] [Indexed: 11/19/2022] Open
Abstract
Background Dengue is the most prevalent mosquito borne infection worldwide. Vertical transmissions after maternal dengue infection to the fetus and pregnancy losses in relation to dengue illness have been reported. The relationship of dengue to miscarriage is not known. Method We aimed to establish the relationship of recent dengue infection and miscarriage. Women who presented with miscarriage (up to 22 weeks gestation) to our hospital were approached to participate in the study. For each case of miscarriage, we recruited 3 controls with viable pregnancies at a similar gestation. A brief questionnaire on recent febrile illness and prior dengue infection was answered. Blood was drawn from participants, processed and the frozen serum was stored. Stored sera were thawed and then tested in batches with dengue specific IgM capture ELISA, dengue non-structural protein 1 (NS1) antigen and dengue specific IgG ELISA tests. Controls remained in the analysis if their pregnancies continued beyond 22 weeks gestation. Tests were run on 116 case and 341 control sera. One case (a misdiagnosed viable early pregnancy) plus 45 controls (39 lost to follow up and six subsequent late miscarriages) were excluded from analysis. Findings Dengue specific IgM or dengue NS1 antigen (indicating recent dengue infection) was positive in 6/115 (5·2%) cases and 5/296 (1·7%) controls RR 3·1 (95% CI 1·0–10) P = 0·047. Maternal age, gestational age, parity and ethnicity were dissimilar between cases and controls. After adjustments for these factors, recent dengue infection remained significantly more frequently detected in cases than controls (AOR 4·2 95% CI 1·2–14 P = 0·023). Interpretation Recent dengue infections were more frequently detected in women presenting with miscarriage than in controls whose pregnancies were viable. After adjustments for confounders, the positive association remained. Dengue is the most prevalent mosquito-borne infection with two billion of the world's population at risk and 100 million infections every year. Dengue is increasingly important due to expansion in the vector's range, increased population density in endemic areas from urbanisation, social and environment change. Miscarriage and stillbirth is associated with dengue when the illness is severe. Dengue can also be transmitted directly from the ill mother through the placenta to the fetus in later pregnancy with variable effect to the fetus. However, dengue infection is asymptomatic to mild only in almost 90% of cases and up to 20% of pregnancies miscarry. Little is known if dengue infection in early pregnancy particularly when it is asymptomatic or mild has an effect on miscarriage. Our study explored the relationship between dengue and miscarriage by looking at recent infection rates amongst women who had miscarried and those whose pregnancies were healthy in an area were dengue is common. Our study finds a positive association between recent dengue infection and miscarriage. This finding may be important in explaining some of the miscarriages in areas where dengue is common. It is also relevant to newly pregnant women from non-dengue travelling to dengue endemic areas.
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Malavige GN, Rostron T, Rohanachandra LT, Jayaratne SD, Fernando N, De Silva AD, Liyanage M, Ogg G. HLA class I and class II associations in dengue viral infections in a Sri Lankan population. PLoS One 2011; 6:e20581. [PMID: 21694773 PMCID: PMC3111420 DOI: 10.1371/journal.pone.0020581] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 05/04/2011] [Indexed: 12/03/2022] Open
Abstract
Background HLA class I and class II alleles have been shown to be associated with the development of dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) in different populations. However, the majority of studies have been based on limited numbers of patients. In this study we aimed to investigate the HLA-class I and class II alleles that are positively and negatively associated with the development of DSS in a cohort of patients with DHF and also the alleles associated with development of DHF during primary dengue infections in a Sri Lankan population. Methodology/Principal Findings The allele frequencies of HLA class I and class II alleles were compared in 110 patients with DHF and 119 individuals from the population who had never reported a symptomatic dengue infection at the time of recruitment. We found that HLA-A*31 (corrected P = 0.01) and DRB1*08 (corrected P = 0.009) were associated with susceptibility to DSS when infected with the dengue virus, during secondary dengue infection. The frequency of DRB1*08 allele was 28.7 times higher than in the normal population in patients with DSS. HLA-A*31 allele was increased 16.6 fold in DHF who developed shock when compared to those who did not develop shock. A*24 (corrected P = 0.03) and DRB1*12 (corrected P = 0.041) were strongly associated with the development of DHF during primary dengue infection. Conclusions/Significance These data suggest that certain HLA alleles confer susceptibility/protection to severe dengue infections. As T cell epitope recognition depend on the HLA type of an individual, it would be now important to investigate how epitope specific T cells associate with primary and secondary dengue infections and in severe dengue infections.
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Affiliation(s)
- Gathsaurie Neelika Malavige
- Department of Microbiology, University of Sri Jayawardanapura, Nugegoda, Sri Lanka
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Tim Rostron
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | | | - S. D. Jayaratne
- Department of Medicine, University of Sri Jayawardanapura, Nugegoda, Sri Lanka
| | - Neluka Fernando
- Department of Microbiology, University of Sri Jayawardanapura, Nugegoda, Sri Lanka
| | | | - Malaka Liyanage
- Department of Microbiology, University of Sri Jayawardanapura, Nugegoda, Sri Lanka
| | - Graham Ogg
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
- Department of Dermatology, Churchill Hospital, Oxford, United Kingdom
- * E-mail:
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Marasinghe JP, Sriyasinghe RY, Wijewantha VI, Gunaratne KARCW, Wijeyaratne CN. Acute acalculous cholecystitis due to dengue hemorrhagic fever during pregnancy. J Obstet Gynaecol Res 2011; 37:1489-92. [PMID: 21564414 DOI: 10.1111/j.1447-0756.2011.01537.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A 29-year-old pregnant woman presented with fever, right hypochondrial pain and fatigability at 29 weeks of gestation. Dengue hemorrhagic fever was diagnosed based on clinical, hematological and serological features. However, ultrasound scanning was suggestive of acute acalculous cholecystitis. The patient was managed symptomatically and made a good recovery 8 days following onset of fever. This is the first case of acute acalculous cholecystitis coinciding with dengue hemorrhagic fever reported during pregnancy from an endemic country in Asia. The possible viral and host factors for the development of such a severe form of disease and preventive measures are discussed.
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Affiliation(s)
- Jeevan P Marasinghe
- Department of Obstetrics and Gynaecology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka.
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Tsai HC, Lin CC, Hong NS, Kuo TN, Huang YY, Lin MYS, Loo TC, Huang KF, Wang JJ, Chen SH. Dengue virus infection in early gestation with delivery of an unaffected fetus and no vertical transmission. Taiwan J Obstet Gynecol 2010; 49:112-4. [PMID: 20466307 DOI: 10.1016/s1028-4559(10)60023-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2009] [Indexed: 11/19/2022] Open
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Adam I, Jumaa AM, Elbashir HM, Karsany MS. Maternal and perinatal outcomes of dengue in PortSudan, Eastern Sudan. Virol J 2010; 7:153. [PMID: 20626851 PMCID: PMC2911427 DOI: 10.1186/1743-422x-7-153] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Accepted: 07/13/2010] [Indexed: 11/26/2022] Open
Abstract
Aim To investigate maternal and perinatal outcomes (maternal death, preterm delivery, low birth weight and perinatal mortality) of dengue at PortSudan and Elmawani hospitals in the eastern Sudan. Method This was a retrospective Cohort study where medical files of women with dengue were reviewed. Results There were 10820 deliveries and 78 (0.7%) pregnant women with confirmed dengue IgM serology at the mean (SD) gestational age of 29.4(8.2) weeks. While the majority of these women had dengue fever (46, 58.9%), hemorrhagic fever and dengue shock syndrome were the presentations in 18 (23.0%) and 12, (15.3%) of these women, respectively. There were 17(21.7%) maternal deaths. Fourteen (17.9%) of these 78 women had preterm deliveries and 19 (24.3%) neonates were admitted to neonatal intensive care unit. Nineteen (24.3%) women gave birth to low birth weight babies. There were seven (8.9%) perinatal deaths. Eight (10.2%) patients delivered by caesarean section due to various obstetrical indications. Conclusion Thus dengue has poor maternal and perinatal outcomes in this setting. Preventive measures against dengue should be employed in the region, and more research on dengue during pregnancy is needed.
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Affiliation(s)
- Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
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Fritel X, Rollot O, Gerardin P, Gauzere BA, Bideault J, Lagarde L, Dhuime B, Orvain E, Cuillier F, Ramful D, Samperiz S, Jaffar-Bandjee MC, Michault A, Cotte L, Kaminski M, Fourmaintraux A. Chikungunya virus infection during pregnancy, Reunion, France, 2006. Emerg Infect Dis 2010; 16:418-25. [PMID: 20202416 DOI: 10.3201/eid1603.091403] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Mother-to-child transmission of chikungunya virus was reported during the 2005-2006 outbreak on Reunion Island, France. To determine the effects of this virus on pregnancy outcomes, we conducted a study of pregnant women in Reunion in 2006. The study population was composed of 1,400 pregnant women (628 uninfected, 658 infected during pregnancy, 27 infected before pregnancy, and 87 infected on unknown dates). We compared pregnancy outcomes for 655 (628 + 27) women not infected during pregnancy with 658 who were infected during pregnancy. Infection occurred during the first trimester for 15% of the infected women, the second for 59%, and the third for 26%. Only hospital admission during pregnancy differed between infected and uninfected women (40% vs. 29%). Other outcomes (cesarean deliveries, obstetric hemorrhaging, preterm births, stillbirths after 22 weeks, birthweight, congenital malformations, and newborn admissions) were similar. This virus had no observable effect on pregnancy outcomes.
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Affiliation(s)
- Xavier Fritel
- Centre Hospitalier Régional de la Réunion, Saint-Denis, France
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Fritel X, Rollot O, Gerardin P, Gauzere BA, Bideault J, Lagarde L, Dhuime B, Orvain E, Cuillier F, Ramful D, Samperiz S, Jaffar-Bandjee MC, Michault A, Cotte L, Kaminski M, Fourmaintraux A. Chikungunya virus infection during pregnancy, Reunion, France, 2006. Emerg Infect Dis 2010. [PMID: 20202416 PMCID: PMC3322036 DOI: 10.3201/eid1604.091403] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Except for prenatal hospital admissions for those infected, this virus had no effect on outcomes. Mother-to-child transmission of chikungunya virus was reported during the 2005–2006 outbreak on Réunion Island, France. To determine the effects of this virus on pregnancy outcomes, we conducted a study of pregnant women in Réunion in 2006. The study population was composed of 1,400 pregnant women (628 uninfected, 658 infected during pregnancy, 27 infected before pregnancy, and 87 infected on unknown dates). We compared pregnancy outcomes for 655 (628 + 27) women not infected during pregnancy with 658 who were infected during pregnancy. Infection occurred during the first trimester for 15% of the infected women, the second for 59%, and the third for 26%. Only hospital admission during pregnancy differed between infected and uninfected women (40% vs. 29%). Other outcomes (cesarean deliveries, obstetric hemorrhaging, preterm births, stillbirths after 22 weeks, birthweight, congenital malformations, and newborn admissions) were similar. This virus had no observable effect on pregnancy outcomes.
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Affiliation(s)
- Xavier Fritel
- Centre Hospitalier Régional de la Réunion, Saint-Denis, France
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Pouliot SH, Xiong X, Harville E, Paz-Soldan V, Tomashek KM, Breart G, Buekens P. Maternal dengue and pregnancy outcomes: a systematic review. Obstet Gynecol Surv. 2010;65:107-118. [PMID: 20100360 DOI: 10.1097/ogx.0b013e3181cb8fbc] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
UNLABELLED To assess the impact of dengue infection during pregnancy on birth outcomes, we conducted a systematic review of 30 published studies (19 case reports, 9 case series, and 2 comparison studies). Studies were identified by searching computerized databases using dengue and dengue hemorrhagic fever, cross-referenced with pregnancy, preterm birth or delivery, low birth weight, small-for-gestational age, spontaneous abortion, pre-eclampsia, eclampsia, or fetal death as search terms. The case reports examined showed high rates of cesarean deliveries (44.0%) and pre-eclampsia (12.0%) among women with dengue infection during pregnancy, while the case series showed elevated rates of preterm birth (16.1%) and cesarean delivery (20.4%). One comparative study found an increase in low birth weight among infants born to women with dengue infections during pregnancy, compared with infants born to noninfected women. Vertical transmission was described in 64.0% and 12.6% of women in case reports and case series (respectively), as well as in one comparative study. The authors conclude that there is a risk of vertical transmission, but whether maternal dengue infection is a significant risk factor for adverse pregnancy outcomes is inconclusive. More comparative studies are needed. TARGET AUDIENCE Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES After completion of this educational activity, the participant should be better able to assess symptoms of dengue fever and locations where dengue fever occurs, describe possible perinatal complications of maternal dengue fever, and identify the limitations of available literature describing dengue fever in pregnancy.
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Abstract
Despite advances in peripartum care, maternal morbidity and mortality associated with infections in pregnancy are increasing even in developed countries. Recently published data from the Center for Disease Control's Pregnancy Mortality Surveillance System indicates that although maternal mortality from hemorrhage, embolism, and anesthesia has declined in the United States, the proportion of maternal deaths due to infections has increased. During 1991–7 infection accounted for 13.2% of pregnancy-related deaths overall and 36.3% of abortion-related deaths. The greatest infection risk is found in blacks, older women, women without prenatal care, and women with multiple pregnancy. In the United States pregnancy rates are stable or increasing in these groups. Infection is also a major cause of morbidity and mortality for the fetus and newborn. Many perinatal infections are associated with intra-uterine growth retardation and low birthweight, or cause fetal and neonatal brain injury. Infections, particularly bacterial vaginosis and chorioamnionitis, can result in preterm delivery of live-born infants (delivery before 37 weeks gestation), or stillbirth. A multitude of immunologic, endocrinologic, metabolic, physiologic, and anatomic changes influence the likelihood and course of many infections during pregnancy. Some of these changes are intrinsic, and occur in all normal pregnancies, while others occur to varying degrees in normal and abnormal pregnancies.
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Abstract
Despite centuries of control efforts, mosquito-borne diseases are flourishing worldwide. With a disproportionate effect on children and adolescents, these conditions are responsible for substantial global morbidity and mortality. Malaria kills more than 1 million children annually, chiefly in sub-Saharan Africa. Dengue virus has expanded its range over the past several decades, following its principal vector, Aedes aegypti, back into regions from which it was eliminated in the mid-20th century and causing widespread epidemics of hemorrhagic fever. West Nile virus has become endemic throughout the Americas in the past 10 years, while chikungunya virus has emerged in the Indian Ocean basin and mainland Asia to affect millions. Japanese encephalitis virus, too, has expanded its range in the Indian subcontinent and Australasia, mainly affecting young children. Filariasis, on the other hand, is on the retreat, the subject of a global eradication campaign. Efforts to limit the effect of mosquito-borne diseases in endemic areas face the twin challenges of controlling mosquito populations and delivering effective public health interventions. Travelers to areas endemic for mosquito-borne diseases require special advice on mosquito avoidance, immunizations, and malaria prophylaxis.
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Affiliation(s)
- Michael A Tolle
- Department of Pediatrics, Baylor College of Medicine, Baylor International Pediatric AIDS Initiative, Houston, TX, USA
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Torres-Cepeda D, Santos-Bolívar J, Peña-Paredes E, Reyna-Villasmil E. [Dengue and pregnancy]. Med Clin (Barc) 2009; 132:36. [PMID: 19174065 DOI: 10.1016/j.medcli.2008.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 07/15/2008] [Indexed: 10/20/2022]
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Abstract
BACKGROUND Vertical dengue virus transmissions have been infrequently described. To date there are no published data on long-term outcome and antibody kinetics of infants who were infected in utero. This is the first report of vertical dengue transmission with 12 months follow-up evolution of antibody and the clinical outcome. METHODS Three mother-infant pairs were confirmed to have perinatally dengue infection by serology, viral isolation, or reverse transcription polymerase chain reaction (RT-PCR). The infants were followed clinically at 1, 2, 4, 6, 9, and 12 months. Sera were collected at 1, 6, and 12 months of age for serologic testing. RESULTS Three mothers developed symptomatic dengue infection 1 day, 12 days, and 5 weeks before delivery of their infants. The first infant developed presumed bacterial illness on day 6 of life. Dengue virus serotype 1 was detected by RT-PCR and viral isolation. The second infant developed fever, petechiae, and hepatomegaly 9 hours after birth. Dengue virus serotype 2 was detected by RT-PCR. The third infant was asymptomatic. All mothers and infants had uneventful recoveries. One year follow-up revealed normal growth and development in all infants. The pattern of antibody kinetics suggested primary infection in the first and second infants, and the transferred antibody without infection in the third infant. CONCLUSIONS In endemic areas, dengue infection can cause an acute febrile illness in pregnant women and sepsis-like illness in neonates. Vertical infection did not result in long-term sequelae.
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Tan PC, Rajasingam G, Devi S, Omar SZ. Dengue Infection in Pregnancy: Prevalence, Vertical Transmission, and Pregnancy Outcome. Obstet Gynecol 2008; 111:1111-7. [DOI: 10.1097/aog.0b013e31816a49fc] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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