Dengue fever and pregnancy - a review and comment.

BACKGROUND

The increasing incidence of dengue with the concomitant rise in travel during pregnancy makes it likely that a pregnant woman will plan travel to or present after travel to endemic areas.

METHOD

Literature search and communication with researchers.

RESULTS

Case reports of dengue during pregnancy, the peripartum period and neonatal dengue were found. There is little systematic research.

CONCLUSIONS

Pregnancy appears not to increase the incidence or severity of dengue, but some case reports suggest that dengue may predispose to certain pregnancy complications. Transplacental infection occurs, but protective antibodies pass transplacentally and fetal effects may be minimal given sufficient immune response. In near-term disease, severe fetal or neonatal illness and death may occur. Such illness may also predispose the newborn to subsequent dengue hemorrhagic fever. Clinicians should be aware that presentation in either maternal or neonatal disease may be atypical and confound diagnosis. Women in late pregnancy should avoid travel to areas of ongoing disease, and those earlier in pregnancy should consider dengue a serious hazard. If travel is unavoidable, mosquito avoidance measures are mandated. If a woman acquires dengue fever while pregnant, conservative medical and obstetrical management are the treatments of choice. Further research is required.