Adverse outcomes and their predictors of dengue fever in pregnancy; a cross sectional study with a follow up

Antenatal dengue infection presents substantial risks to maternal, fetal, and neonatal health, particularly in dengue-endemic regions such as Sri Lanka. This retrospective cross-sectional study with a follow up aimed to investigate the adverse outcomes of antenatal dengue infection and identify predictive parameters associated with maternal, fetal, and neonatal complications. A total of 115 pregnant women with laboratory-confirmed dengue infection admitted to two tertiary referral hospitals in Sri Lanka were followed from admission until delivery and discharge. Data on clinical and laboratory outcome variables were collected and analyzed using descriptive and inferential statistics.

Results revealed a seasonal pattern of dengue infections, with the majority occurring between April and July. Dengue fever (DF) accounted for the majority of cases, followed by dengue hemorrhagic fever (DHF) and dengue expanded syndrome (DES). Maternal adverse outcomes were observed in 27.8% of cases, with predictors including dengue category, trimester of infection, platelet count, and AST levels. Fetal adverse outcomes affected 8.1% of cases, while neonatal adverse outcomes occurred in 28.7% of live births, with transplacental transmission observed in 13.3% of cases.

This study underscores the urgent need for early detection and management of antenatal dengue infection to mitigate adverse outcomes. Identifying predictors of adverse maternal outcomes, such as dengue category and trimester of infection, alongside vigilant monitoring of platelet and AST levels, is crucial for optimizing outcomes. Further research is warranted to develop robust prediction models and refine management strategies for this vulnerable population.

Author summary

This study is diving into how dengue fever affects pregnant women in and how to predict them. Dengue is a huge problem worldwide, with millions of cases each year. Dengue fever is caused by a virus spread by mosquitoes. Being pregnant makes dealing with dengue even harder. Pregnancy brings changes to a woman’s body, which can make it tough to spot and treat dengue. We followed up pregnant women with confirmed dengue infections from when they were admitted to the hospital until they had their babies. Our study looked at things like their symptoms, lab results, and any problems they had.

Study found that more than a quarter of the women had serious problems because of dengue. Some even died, or had issues like liver problems or brain swelling. Study found some laboratory markers which could be used to predict these bad outcomes. It’s important for doctors to keep an eye on pregnant women with dengue and to act fast if things get serious.