Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
Obstet Gynecol Surv. 2010 Feb;65(2):107-18. doi: 10.1097/OGX.0b013e3181cb8fbc.
To assess the impact of dengue infection during pregnancy on birth outcomes, we conducted a systematic review of 30 published studies (19 case reports, 9 case series, and 2 comparison studies). Studies were identified by searching computerized databases using dengue and dengue hemorrhagic fever, cross-referenced with pregnancy, preterm birth or delivery, low birth weight, small-for-gestational age, spontaneous abortion, pre-eclampsia, eclampsia, or fetal death as search terms. The case reports examined showed high rates of cesarean deliveries (44.0%) and pre-eclampsia (12.0%) among women with dengue infection during pregnancy, while the case series showed elevated rates of preterm birth (16.1%) and cesarean delivery (20.4%). One comparative study found an increase in low birth weight among infants born to women with dengue infections during pregnancy, compared with infants born to noninfected women. Vertical transmission was described in 64.0% and 12.6% of women in case reports and case series (respectively), as well as in one comparative study. The authors conclude that there is a risk of vertical transmission, but whether maternal dengue infection is a significant risk factor for adverse pregnancy outcomes is inconclusive. More comparative studies are needed.
Obstetricians & Gynecologists, Family Physicians.
After completion of this educational activity, the participant should be better able to assess symptoms of dengue fever and locations where dengue fever occurs, describe possible perinatal complications of maternal dengue fever, and identify the limitations of available literature describing dengue fever in pregnancy.
评估妊娠期间登革热感染对妊娠结局的影响,我们对 30 篇已发表的研究进行了系统评价(19 篇病例报告、9 篇病例系列研究和 2 项对照研究)。通过计算机数据库检索登革热和登革出血热,并用妊娠、早产或分娩、低出生体重、小于胎龄儿、自然流产、先兆子痫、子痫或胎儿死亡等术语进行交叉对照,以确定研究。所检查的病例报告显示,患有妊娠期间登革热的女性中,剖宫产(44.0%)和先兆子痫(12.0%)的发生率较高,而病例系列研究显示早产(16.1%)和剖宫产(20.4%)的发生率较高。一项对照研究发现,与未感染的女性相比,患有妊娠期间登革热的女性所生婴儿的低出生体重发生率增加。在病例报告和病例系列研究中,分别有 64.0%和 12.6%的女性描述了垂直传播,一项对照研究也描述了垂直传播。作者得出结论,存在垂直传播的风险,但母体登革热感染是否是不良妊娠结局的重要危险因素尚无定论。需要更多的对照研究。
妇产科医师、家庭医生。
完成本项教育活动后,参与者应能够更好地评估登革热的症状和发生地点,描述母体登革热可能发生的围产期并发症,并识别描述妊娠期间登革热的现有文献的局限性。