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Maternal Dengue and Pregnancy Outcomes: A Systematic Review

Pouliot, Sawyer H. MPH*; Xiong, Xu MD, DrPH; Harville, Emily PhD; Paz-Soldan, Valerie PhD§; Tomashek, Kay M. MD, MPH, DTM; Breart, Gerard MD**; Buekens, Pierre MD, PhD††,‡‡

Obstetrical & Gynecological Survey: February 2010 - Volume 65 - Issue 2 - p 107-118
doi: 10.1097/OGX.0b013e3181cb8fbc
CME Program: CME REVIEW ARTICLES 4, 5, AND 6: CME REVIEW ARTICLE 4

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.

*Doctoral Student, §Research Assistant Professor, Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA; †Associate Professor, ‡Assistant Professor, Department of Epidemiology, Tulane University, New Orleans, LA; ¶Acting Branch Chief and Chief of Epidemiology Activity, Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, San Juan, PR; **Director, INSERM, URMS 953, UPMC, Epidemiological Research Unit on Perinatal Health and Women’s and Children’s Health, Hospital Tenon, Paris, France; and ††Dean, ‡‡Professor, Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credits™ can be earned in 2006. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

Unless otherwise noted below, each faculty’s spouse/life partner (if any) has nothing to disclose.

The authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.

The Faculty and Staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity.

Reprint requests to: Sawyer H. Pouliot, MPH, Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, Suite 2200, New Orleans, LA 70112. E-mail: spouliot@tulane.edu.

© 2010 Lippincott Williams & Wilkins, Inc.