Estimating the Risk of Vertical Transmission of Dengue: A Prospective Study

被引:54
作者
Basurko, Celia [1 ,2 ]
Matheus, Severine [3 ]
Hilderal, Helene [1 ]
Everhard, Sibille [1 ]
Restrepo, Marion [1 ,4 ,5 ]
Cuadro-Alvarez, Emma [6 ]
Lambert, Veronique [4 ]
Boukhari, Rachida [7 ]
Duvernois, Jean-Pierre [8 ]
Favre, Anne [9 ]
Nacher, Mathieu [1 ,2 ]
Carles, Gabriel [4 ]
机构
[1] Ctr Hosp Cayenne, Ctr Invest Clin Antilles Guyane, INSERM, CIC1424, Ave Flamboyants, Cayenne 97300, French Guiana
[2] Univ Guyane, Ecosyst Amazoniens & Pathol Trop, Equipe EA3593, Cayenne, French Guiana
[3] Inst Pasteur Guyane Cayenne, Ctr Natl Reference Arbovirus, Lab Virol, Cayenne, French Guiana
[4] Ctr Hosp Ouest Guyanais, Serv Gynecol & Obst, St Laurent Du Maroni, French Guiana
[5] Ctr Hosp Ouest Guyanais, Pole Sante Publ, St Laurent Du Maroni, French Guiana
[6] Ctr Hosp Cayenne, Serv Pediat, Cayenne, French Guiana
[7] Ctr Hosp Ouest Guyanais, Serv Anal Med, St Laurent Du Maroni, French Guiana
[8] Ctr Med Chirurg Kourou, Serv Gynecol & Obst, Croix Rouge Francaise, Kourou, French Guiana
[9] Reseau Perinat Guyane, Cayenne, French Guiana
关键词
INFECTION; VIRUS; PREGNANCY; VECTOR;
D O I
10.4269/ajtmh.16-0794
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The incidence of dengue worldwide is increasing rapidly. A better understanding of dengue transmission may help improve interventions against this major public health problem. The virus is mostly transmitted by vectors. There are, however, other modes of transmission, notably mother-to-child transmission or vertical transmission. We studied a prospective cohort of 54 women who had dengue while pregnant during the 2012-2013 epidemic in French Guiana to estimate the mother-to-child transmission rate and assess the clinical and biological presentation of neonatal dengue. The rate of vertical transmission was between 18.5% (95% confidence interval [CI]: 9.25-31.4) and 22.7% (95% CI: 11.5-37.8), depending on the calculation method used. Mother-to-child transmission occurred both in early and late pregnancy. There were 52 births, including three newborns who presented neonatal dengue with warning signs requiring platelet transfusion. This quantification of the mother-to-child transmission of dengue highlights three points: first, vertical transmission of dengue is not negligible; second, it is more frequent when maternal dengue occurs late during pregnancy near delivery; and third, reliable diagnostic tests must be used to allow the diagnosis of vertical transmission. Our findings indicate that if there is a known history of maternal dengue during pregnancy, or if there is fever during the 15 days before term, cord blood and placenta should be sampled after delivery and tested for the virus, and the newborn should be closely monitored during the postpartum period.
引用
收藏
页码:1826 / 1832
页数:7
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