Zinia T Nujum1, Chellamma Nirmala2, Krishnapillai Vijayakumar3, Muthubeevi Saboora Beegum4, Rajahamsan Jyothi5. 1. Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India. 2. Obstetrics and Gynaecology, Government Medical College, Thiruvananthapuram, India. 3. Community Medicine, Amrita Institute of Medical Sciences, Kochi, India. 4. Biochemistry, Government Medical College, Thiruvananthapuram, India. 5. Microbiology, Government Medical College, Thiruvananthapuram, India.
Abstract
BACKGROUND: The primary objectives of the study were to determine the incidence of dengue and outcomes associated with dengue among pregnant women. METHODS: A prospective cohort study was done among 1579 antenatal women in an endemic region in India. Dengue immunoglobulin G (IgG) was tested in 490 women at baseline. Follow-up phone calls and visits were done until 1 week after delivery. In 70 seronegative women, dengue IgG was repeated to identify seroconversion. Incidence proportions, incidence rates, relative risks, attributable risks and population attributable risks along with their 95% confidence intervals (CIs) were calculated. Propensity score methods were used for multivariate assessment of confounding and analysis was repeated with a matched dataset. RESULTS: The seroprevalence of dengue was 30.41% (95% CI 26.45 to 34.59). NS1 positivity detected 78% of dengue in pregnancy. There were no abortions or maternal or newborn deaths. Dengue was significantly associated with delivery complications (adjusted odds ratio [OR] 10.28 [95% CI 4.79 to 22.01]), newborn problems (adjusted OR 5.29 [95% CI 2.89 to 9.70]) and newborn admissions (adjusted OR 5.24 [95% CI 2.36 to 11.65]). Overweight dengue patients had a significantly higher risk of preterm deliveries and higher adverse outcome scores. CONCLUSIONS: Screening of febrile antenatal women for dengue in endemic areas can result in early diagnosis and reduce complications. The dual burden of communicable and non-communicable diseases in pregnancy is a real challenge.
BACKGROUND: The primary objectives of the study were to determine the incidence of dengue and outcomes associated with dengue among pregnant women. METHODS: A prospective cohort study was done among 1579 antenatal women in an endemic region in India. Dengue immunoglobulin G (IgG) was tested in 490 women at baseline. Follow-up phone calls and visits were done until 1 week after delivery. In 70 seronegative women, dengue IgG was repeated to identify seroconversion. Incidence proportions, incidence rates, relative risks, attributable risks and population attributable risks along with their 95% confidence intervals (CIs) were calculated. Propensity score methods were used for multivariate assessment of confounding and analysis was repeated with a matched dataset. RESULTS: The seroprevalence of dengue was 30.41% (95% CI 26.45 to 34.59). NS1 positivity detected 78% of dengue in pregnancy. There were no abortions or maternal or newborn deaths. Dengue was significantly associated with delivery complications (adjusted odds ratio [OR] 10.28 [95% CI 4.79 to 22.01]), newborn problems (adjusted OR 5.29 [95% CI 2.89 to 9.70]) and newborn admissions (adjusted OR 5.24 [95% CI 2.36 to 11.65]). Overweight dengue patients had a significantly higher risk of preterm deliveries and higher adverse outcome scores. CONCLUSIONS: Screening of febrile antenatal women for dengue in endemic areas can result in early diagnosis and reduce complications. The dual burden of communicable and non-communicable diseases in pregnancy is a real challenge.