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妊娠期间登革病毒感染的母婴和胎儿-新生儿结局。

Maternal and foetal-neonatal outcomes of dengue virus infection during pregnancy.

机构信息

Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India.

Internal Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India.

出版信息

Trop Med Int Health. 2022 Jul;27(7):619-629. doi: 10.1111/tmi.13783. Epub 2022 Jun 11.

Abstract

OBJECTIVE

Given that women of reproductive age in dengue-endemic areas are at risk of infection, it is necessary to determine whether dengue virus (DENV) infection during pregnancy is associated with adverse outcomes. The aim of this systematic review and meta-analysis is to investigate the consequences of DENV infection in pregnancy on various maternal and foetal-neonatal outcomes.

METHODS

A systematic literature search was undertaken using PubMed, Google Scholar, and Embase till December 2021. Mantel-Haenszel risk ratios were calculated to report overall effect size using random effect models. The pooled prevalence was computed using the random effect model. All statistical analyses were performed on MedCalc Software.

RESULT

We obtained data from 36 studies involving 39,632 DENV-infected pregnant women. DENV infection in pregnancy was associated with an increased risk of maternal mortality (OR = 4.14 [95% CI, 1.17-14.73]), stillbirth (OR = 2.71 [95% CI, 1.44-5.10]), and neonatal deaths (OR = 3.03 [95% CI, 1.17-7.83]) compared with pregnant women without DENV infection. There was no significant statistical association established between maternal DENV infection and the outcomes of preterm birth, maternal bleeding, low birth weight in neonates, and risk of miscarriage. Pooled prevalences were 14.9% for dengue shock syndrome, 14% for preterm birth, 13.8% for maternal bleeding, 10.1% for low birth weight, 6% for miscarriages, and 5.6% for stillbirth.

CONCLUSION

DENV infection in pregnant women may be associated with adverse outcomes such as maternal mortality, stillbirth, and neonatal mortality. Hence, pregnant women should be considered an at-risk population for dengue management programmes.

摘要

目的

鉴于生殖年龄的妇女在登革热流行地区有感染的风险,因此需要确定妊娠期间登革病毒(DENV)感染是否与不良结局有关。本系统综述和荟萃分析的目的是研究妊娠期间 DENV 感染对各种母婴和胎儿-新生儿结局的影响。

方法

通过 PubMed、Google Scholar 和 Embase 进行系统文献检索,检索时间截至 2021 年 12 月。使用随机效应模型计算 Mantel-Haenszel 风险比以报告总体效应量。使用随机效应模型计算合并患病率。所有统计分析均在 MedCalc 软件上进行。

结果

我们从 36 项研究中获得了数据,这些研究涉及 39632 名感染 DENV 的孕妇。与未感染 DENV 的孕妇相比,妊娠期间 DENV 感染与产妇死亡率(OR=4.14[95%CI,1.17-14.73])、死胎(OR=2.71[95%CI,1.44-5.10])和新生儿死亡(OR=3.03[95%CI,1.17-7.83])的风险增加相关。母亲 DENV 感染与早产、母亲出血、新生儿低体重和流产风险之间没有建立显著的统计学关联。登革热休克综合征、早产、母亲出血、低体重儿、流产和死胎的合并患病率分别为 14.9%、14%、13.8%、10.1%、6%和 5.6%。

结论

孕妇感染 DENV 可能与不良结局相关,如产妇死亡率、死胎和新生儿死亡率。因此,孕妇应被视为登革热管理计划的高危人群。

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