MATERNAL AND FETAL OUTCOMES ASSOCIATED WITH DENGUE FEVER: A SYSTEMATIC REVIEW AND META-ANALYSIS
Author(s)
Giovana Vesentini, PhD1, Alexandre Miralha, PhD2, Barshana Karki, MSc1, Débora Damasceno, PhD1.
1Universidade Estadual Paulista, Botucatu, Brazil, 2Universidade Federal do Amazonas, Manaus, Brazil.
1Universidade Estadual Paulista, Botucatu, Brazil, 2Universidade Federal do Amazonas, Manaus, Brazil.
OBJECTIVES: Following subsequent major outbreaks across endemic regions, new evidence has accumulated on the impact of dengue on materno-fetal and neonatal outcomes. However, an up-to-date and comprehensive synthesis remains lacking, limiting its usefulness for clinical decision-making, the design of effective public health and resource allocation strategies. This research aims to synthesize the available evidence on maternal, fetal, and neonatal outcomes associated with dengue fever infection during pregnancy.
METHODS: A comprehensive search was performed using PubMed (MEDLINE), Embase, Web of Science (SciELO), and Global Index Medicus databases from their inception to 8 June 2026, without restrictions on publication date or language. Eligible studies were observational in design and reported fetal outcomes in women with dengue infection during pregnancy. Two reviewers independently screened titles and abstracts to determine eligibility and independently extracted data and assessed the quality of studies. Outcomes were analyzed as dichotomous variables with random effect models and heterogeneity with I2 statistics.
RESULTS: Out of 4,306 studies screened, 76 studies (including 91 publications) met the criteria. Pairwise meta-analysis showed no evidence of difference between groups in miscarriages (OR 1.6 [95%CI 0.16, 15.86], p=0.47; I2=0%), hemorrhage during delivery (OR 1.2 [95%CI 0.03, 43.39], p=0.64; I2=0%) and neonatal mortality (OR 1.14 [95%CI 0.76, 1.71], p=0.47; I2=0%). However, dengue during pregnancy was associated with increased risk of stillbirth (OR 1.8 [95%CI 1.59, 2.03], p<0.0001; I2=0%), low birthweight (OR 1.18 [95%CI 1.13, 1.23], p<0.0001; I2=0%), preterm birth (OR 1.10 [95%CI 1.02, 1.19], p=0.016; I2=29.1%), general malformation (OR 8.39 [95%CI 4.65, 15.14], p=0.014; I2=0%) and maternal mortality (OR 6.64 [95%CI 2.36, 18.73], p=0.003; I2=23.5%).
CONCLUSIONS: This systematic review and meta-analysis indicates that dengue infection during pregnancy may increase the risk of adverse maternal and fetal outcomes. These findings highlight the importance of recognizing pregnant women as a vulnerable group in dengue prevention and management programmes.
METHODS: A comprehensive search was performed using PubMed (MEDLINE), Embase, Web of Science (SciELO), and Global Index Medicus databases from their inception to 8 June 2026, without restrictions on publication date or language. Eligible studies were observational in design and reported fetal outcomes in women with dengue infection during pregnancy. Two reviewers independently screened titles and abstracts to determine eligibility and independently extracted data and assessed the quality of studies. Outcomes were analyzed as dichotomous variables with random effect models and heterogeneity with I2 statistics.
RESULTS: Out of 4,306 studies screened, 76 studies (including 91 publications) met the criteria. Pairwise meta-analysis showed no evidence of difference between groups in miscarriages (OR 1.6 [95%CI 0.16, 15.86], p=0.47; I2=0%), hemorrhage during delivery (OR 1.2 [95%CI 0.03, 43.39], p=0.64; I2=0%) and neonatal mortality (OR 1.14 [95%CI 0.76, 1.71], p=0.47; I2=0%). However, dengue during pregnancy was associated with increased risk of stillbirth (OR 1.8 [95%CI 1.59, 2.03], p<0.0001; I2=0%), low birthweight (OR 1.18 [95%CI 1.13, 1.23], p<0.0001; I2=0%), preterm birth (OR 1.10 [95%CI 1.02, 1.19], p=0.016; I2=29.1%), general malformation (OR 8.39 [95%CI 4.65, 15.14], p=0.014; I2=0%) and maternal mortality (OR 6.64 [95%CI 2.36, 18.73], p=0.003; I2=23.5%).
CONCLUSIONS: This systematic review and meta-analysis indicates that dengue infection during pregnancy may increase the risk of adverse maternal and fetal outcomes. These findings highlight the importance of recognizing pregnant women as a vulnerable group in dengue prevention and management programmes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH10
Topic
Clinical Outcomes, Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas