Os efeitos maternos, fetais e infantis decorrentes da infecção por dengue durante a gestação em Rio Branco, Acre, Brasil, 2007-2012

Feitoza, Helena Albuquerque Catão; Koifman, Sérgio; Koifman, Rosalina Jorge; Saraceni, Valéria

doi:10.1590/0102-311x00178915

Cited by 23 publications

(17 citation statements)

References 12 publications

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“…The results of this study are consistent with the literature that shows a higher maternal mortality ratio associated with dengue, mainly among those who developed severe dengue. In a Brazilian cohort in Rio Branco, the maternal mortality ratio in the dengue exposed group was 13 times the mean maternal mortality ratio of the area 8 as opposed to our finding of 3 times higher. The percentage of maternal deaths among pregnant women with dengue in the case series studies varied from 6.6% in Sri Lanka 19 to 21.7% in the South Sudan 6 , whereas we see 0.07%.…”

Section: Discussioncontrasting

confidence: 99%

“…Dengue during pregnancy has been associated with poor fetal and maternal outcomes. There is some evidence that the risk of severe dengue and of hospitalization due to dengue is higher among pregnant compared with non-pregnant women 5 and a number of case series have reported maternal deaths, and other complications such as bleeding and iincreased caesarean section rates as being associated with dengue 6 , Two small cohorts comparing pregnant women exposed to dengue or in Brazil and Colombia to those not exposed found more maternal deaths among the dengue exposed group 7 , 8 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dengue in pregnancy and maternal mortality: a cohort analysis using routine data

Paixão

Harron

Campbell

et al. 2018

Sci Rep

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Dengue is a mosquito-borne disease with major public health importance due to its growing incidence and geographical spread. There is a lack of knowledge on its contribution to maternal death. We conducted a population-based cohort study to investigate the association between symptomatic dengue during pregnancy and deaths in Brazil from 2007 to 2012. We did this by linking routine records of confirmed dengue cases to records of deaths of women who had a live birth. Using the Firth method, we estimated odds ratios for maternal deaths associated with dengue during pregnancy. Dengue increased the risk of maternal death by 3 times (95%CI,1.5–5.8) and dengue haemorrhagic fever increased the risk of maternal death by 450 times (95%CI,186.9–1088.4) when compared to mortality of pregnant women without dengue. The increase in risk occurred mostly during acute dengue 71.5 (95%CI,32.8–155.8), compared with no dengue cases. This study showed an increased risk of adverse outcomes in pregnant women with dengue. Therefore in areas where dengue is circulating, the health of pregnant women should be not only a public health priority, but health professionals attending pregnant women with dengue should more closely observe these patients to be able to intervene in a timely way and avoid deaths.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dengue in pregnancy and maternal mortality: a cohort analysis using routine data

Paixão

Harron

Campbell

et al. 2018

Sci Rep

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“…Previous studies suggest that the virus infections during the pregnancy are associated with the high rate of complications in fetuses, such as the spontaneous abortion, the premature birth, and the intrauterine growth restriction [20,21]. To further elucidate whether SARS-CoV-2 infection of pregnant women affected fetuses, we collected the blood samples of neonates at birth from mothers with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

The metabolic and immunological characteristics of pregnant women with COVID-19 and their neonates

Zhou

Wang

Zhao

et al. 2020

Eur J Clin Microbiol Infect Dis

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Our aim was to investigate whether SARS-CoV-2 infection raised high risks of late pregnancy complications, and posed health problems in fetuses and neonates. We analyzed the data of COVID-19 pregnant women with COVID-19 during late pregnancy and their neonates. Eleven out of 16 (69%) pregnant women with COVID-19 had ++ or +++ of ketone body in urine. The blood uric acid of pregnant patients was 334 μmol/L (IQR, 269-452). D-dimer and FDP in pregnant patients were 3.32 mg/L (IQR, 2.18-4.21) and 9.6 mg/L (IQR, 5.9-12.4). Results of blood samples collected at birth showed that 16 neonates had leukocytes (15.7 × 10 9 /L (IQR, 13.7-17.2)), neutrophils (11.1 × 10 9 /L (IQR, 9.2-13.2)), CK (401 U/L (IQR, 382-647)), and LDH (445 U/L (IQR, 417-559)). Twenty-four hours after birth, a neonate from COVID-19 woman had fever and positive of SARS-CoV-2 gene. Another woman had strongly positive for SARS-CoV-2 gene (+++) for 4 weeks, and delivered one neonate who had SARS-CoV-2 IgM (46 AU/mL) and IgG (140 AU/mL) on day 1 after birth. In the third trimester, COVID-19 infection in pregnant patients raised high risks of ketonuria, hypercoagulable state, and hyperfibrinolysis, which may lead to severe complications. COVID-19 increased the inflammatory responses of placenta, and fetuses and neonates had potential organ dysregulation and coagulation disorders. There was a potential intrauterine transmission while pregnant women had high titer of SARS-CoV-2, but it is necessary to detect SARS-CoV-2 in the blood cord, placenta, and amniotic fluid to further confirm intrauterine infection of fetuses.

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“…Although there is no consensus regarding the effects of the disease on this vulnerable group, some studies indicate that vertical transmission may occur and cause serious consequences, such as preterm delivery and fetal death [24,25,26,27,28]. There is some evidence that the risk of severe dengue and hospitalization is higher among pregnant women compared to non-pregnant women [29] and that the maternal natural immunosuppression during pregnancy may favor the occurrence of a more severe infection [30]. Immunohistochemical analysis revealed a systemic involvement of infection with mononuclear cells targeted to all of the tissues analyzed.…”

Section: Introductionmentioning

confidence: 99%

A Stillborn Multiple Organs’ Investigation from a Maternal DENV-4 Infection: Histopathological and Inflammatory Mediators Characterization

Nunes

Nogueira

Coelho

et al. 2019

Viruses

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Dengue virus (DENV) is an emerging virus involved in outbreaks in Brazil. The association between the virus and vertical transmission, with disorders in the placenta, has raised a worldwide concern. On the 29th gestational week, a pregnant woman presented severe complications due to a DENV infection leading to maternal and fetus death. Postmortem analysis of fetal organs demonstrated the presence of DENV using reverse transcriptase polymerase chain reaction (RT-PCR) in the fetal brain and DENV non-structural protein 3 (NS3) staining in placenta and several peripheral fetal tissues, such as the brain, liver, lungs, and spleen. Histological analysis of the placenta and fetal organs revealed different types of tissue abnormalities, which included inflammation, hemorrhage, edema, and necrosis in placenta and tissue disorganization in the fetus, such as spongiform parenchyma, microglial inflammation, steatosis, hyalinose arteriolar, inflammatory cells in the alveolar septa, and disorganization of the lymphoid follicle. Increased cellularity (macrophage, Hofbauer cells and TCD8+ lymphocytes) and up-regulation of inflammatory mediators such as IFN-γ, TNF-α, RANTES/CCL5, MCP1/CCL2, and VEGF/R2 were detected in the liver, lung, spleen, brain, and placenta, supporting placental and fetus peripheral tissues inflammation. Maternal infection leading to the production of those vascular mediators may alter the vascular permeability, facilitating the virus entry and tissue and barrier dysfunction.

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Os efeitos maternos, fetais e infantis decorrentes da infecção por dengue durante a gestação em Rio Branco, Acre, Brasil, 2007-2012

Cited by 23 publications

References 12 publications

Dengue in pregnancy and maternal mortality: a cohort analysis using routine data

Dengue in pregnancy and maternal mortality: a cohort analysis using routine data

The metabolic and immunological characteristics of pregnant women with COVID-19 and their neonates

A Stillborn Multiple Organs’ Investigation from a Maternal DENV-4 Infection: Histopathological and Inflammatory Mediators Characterization

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