Symptomatic dengue infection during pregnancy and livebirth outcomes in Brazil, 2007–13: a retrospective observational cohort study

Nascimento, Laura Branquinho do; Siqueira, Claudio Morais; Coelho, Giovanini Evelim; Siqueira Júnior, João Bosco

Symptomatic dengue infection during pregnancy and livebirth outcomes in Brazil, 2007–13: a retrospective observational cohort study

Data

2017

Autores

Nascimento, Laura Branquinho do

Siqueira, Claudio Morais

Coelho, Giovanini Evelim

Siqueira Júnior, João Bosco

Resumo

Background Dengue is a major public health challenge in Brazil. We assessed the relationship between symptomatic dengue infection during pregnancy and adverse birth outcomes in the country between 2007 and 2013. Methods We did a retrospective observational cohort study using information reported in the Brazilian national reportable disease information system (SINAN) and the livebirth information system (SINASC) databases. We probabilistically linked confirmed dengue-positive and dengue-negative pregnancies with live childbirths using Fine-Grained Record Integration and Linkage (FRIL) software. We also included an external reference population of randomly selected newborn babies. Pregnancy was adopted as the unit of analysis. We assessed the relationship between symptomatic dengue infection during pregnancy and adverse birth outcomes, using multivariable logistic regression adjusted for relevant covariates. Findings 3898 dengue-positive pregnant women, 3165 dengue-negative women, and 3898 newborn babies from the reference population were included in the analysis. Preterm birth occurred in 322 (8·4%) of 3821 cases in the dengue-positive group versus 324 (10·4%) of 3101 in the dengue-negative group (unadjusted analysis: relative risk [RR] 0·81, 95% CI 0·70–0·93; adjusted analysis: odds ratio [OR] 1·26, 95% CI 1·06–1·49, p=0·006) and 349 (9·1%) of 3818 in the reference population (RR 0·92, 0·80–1·07; OR 0·98, 0·83–1·16, p=0·84). The prevalence of low birthweight (<2500 g) was similar for dengue-positive women and dengue-negative women (8·3% [322 of 3897] vs 9·8% [310 of 3163]; OR 1·17, 95% CI 0·99–1·39, p=0·07), and in the reference population (8·3% vs 9·0% [350 of 3895]; OR 1·00, 0·85–1·17, p=0·97). The prevalence of malformations did not differ significantly for the dengue-positive group (27 [0·7%] of 3789) versus the dengue-negative group (27 [0·9%] of 3059, p=0·51) or versus the reference population (32 [0·9%] of 3738, p=0·56). Interpretation In the adjusted analysis, the risk of preterm birth seems to be increased in women with symptomatic dengue infection during pregnancy. However, symptomatic dengue infection during pregnancy does not appear to be associated with congenital malformations or low birthweight.

Citação

NASCIMENTO, Laura B. et al. Symptomatic dengue infection during pregnancy and livebirth outcomes in Brazil, 2007-13: a retrospective observational cohort study. Lancet Infectious Diseases, New York, v. 17, n. 9, p. 949-956, 2017. DOI: 10.1016/S1473-3099(17)30169-X. Disponível em: https://www.sciencedirect.com/science/article/pii/S147330991730169X?via%3Dihub. Acesso em: 20 jan. 2025.