RT Journal Article
SR Electronic
T1 Dengue during pregnancy and live birth outcomes: a cohort of linked data from Brazil
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e023529
DO 10.1136/bmjopen-2018-023529
VO 9
IS 7
A1 Enny S Paixão
A1 Oona M Campbell
A1 Maria Gloria Teixeira
A1 Maria CN Costa
A1 Katie Harron
A1 Mauricio L Barreto
A1 Maira B Leal
A1 Marcia F Almeida
A1 Laura C Rodrigues
YR 2019
UL http://bmjopen.bmj.com/content/9/7/e023529.abstract
AB Objectives Dengue is the most common viral mosquito-borne disease, and women of reproductive age who live in or travel to endemic areas are at risk. Little is known about the effects of dengue during pregnancy on birth outcomes. The objective of this study is to examine the effect of maternal dengue severity on live birth outcomes.Design and setting We conducted a population-based cohort study using routinely collected Brazilian data from 2006 to 2012.Participating We linked birth registration records and dengue registration records to identify women with and without dengue during pregnancy. Using multinomial logistic regression and Firth method, we estimated risk and ORs for preterm birth (<37 weeks’ gestation), low birth weight (<2500 g) and small for gestational age (<10thcentile). We also investigated the effect of time between the onset of the disease and each outcome.Results We included 16 738 000 live births. Dengue haemorrhagic fever was associated with preterm birth (OR=2.4; 95% CI 1.3 to 4.4) and low birth weight (OR=2.1; 95% CI 1.1 to 4.0), but there was no evidence of effect for small for gestational age (OR=2.1; 95% CI 0.4 to 12.2). The magnitude of the effects was higher in the acute disease period.Conclusion This study showed an increased risk of adverse birth outcomes in women with severe dengue during pregnancy. Medical intervention to mitigate maternal risk during severe acute dengue episodes may improve outcomes for infants born to exposed mothers.