Maternal & perinatal outcome of fever in pregnancy in the context of dengue-A retrospective observational study

Background & objectives: Pregnant women with dengue infection may be at increased risk of adverse maternal-foetal outcomes. This study was conducted to assess the maternal and perinatal outcomes in women who presented with fever and diagnosed to have dengue infection during pregnancy. Methods: A retrospective observational study was conducted on pregnant women admitted with fever, in a tertiary referral centre in South India, during January 2015 to December 2018. We compared outcomes of women diagnosed with dengue with that of women without dengue. The study outcomes included pre-term birth, stillbirth, low-birth weight (LBW), maternal mortality and thrombocytopenia. Results: During the study period, there were six maternal deaths following complications from dengue infection. Higher rates of thrombocytopenia (24.7% vs. 14.6%, P=0.02) were noted among those with recent dengue infection. The risk of still birth was 2.67 [95% confidence interval (CI) 1.09, 6.57], LBW [risk ratio (RR) 1.13, 95% CI 0.87, 1.45] and pre-term birth (RR 1.33, 95% CI 0.89, 1.97) among the cases. Interpretation & conclusions: Occurrence of adverse maternal and foetal outcomes was increased in pregnant women with fever diagnosed with dengue infection. Future studies are needed to formulate the optimum monitoring and treatment strategies in pregnant women, where dengue can have additive adverse effects to other obstetric complications.