Smith Annabelle, Bayrau Bethel Alebel, Ichura Caroline, Altamirano Jonathan, King Charles, Malhotra Indu, Mungai Peter, Mutuku Francis, Mukoko Dunstan, LaBeaud A Désirée
Stanford Medicine, Stanford University, Stanford, California.
Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio.
Am J Trop Med Hyg. 2024 Dec 3;112(2):396-402. doi: 10.4269/ajtmh.24-0387. Print 2025 Feb 5.
Dengue virus (DENV) is the most common arbovirus globally, with its incidence growing dramatically in recent decades. Although the effects of DENV infection during pregnancy are unclear, reported associations with adverse health outcomes include miscarriage, prematurity, and low birth weight. In this study, we used an IgG ELISA to identify mothers exposed to DENV during pregnancy by testing samples obtained from a previous study that followed a cohort of pregnant women in Kenya to investigate parasitic infections during pregnancy. We compared adverse pregnancy and infant health outcomes between seronegative mothers and those who seroconverted. Of the 289 participants tested for DENV exposure during pregnancy, we estimated that ∼12 women (4%) would have been exposed to DENV during their gestation period. However, we found that 34 mothers (11.8%) had been exposed to DENV during pregnancy. None of these mothers were hospitalized during pregnancy because of severe DENV infection, suggesting that many may have undergone asymptomatic seroconversion. The demographic risk factors of socioeconomic status, education level, bed net use, and maternal age were not associated with mild or asymptomatic DENV in pregnancy. Although mild or asymptomatic DENV during pregnancy was not associated with late prematurity, reduced postnatal childhood developmental measures, or adverse maternal pregnancy outcomes, we observed an increased risk of low birth weight. The larger-than-expected burden of DENV in pregnancy in this coastal Kenyan cohort and the observed potential risk of low birth weight provide evidence that a more comprehensive study is warranted to fully understand DENV infection during pregnancy.
登革病毒（DENV）是全球最常见的虫媒病毒，近几十年来其发病率急剧上升。尽管孕期感染登革病毒的影响尚不清楚，但报告显示其与不良健康结局的关联包括流产、早产和低出生体重。在本研究中，我们使用IgG酶联免疫吸附测定法（IgG ELISA），通过检测先前一项针对肯尼亚一组孕妇进行的研究中获取的样本，来确定孕期接触登革病毒的母亲，该研究旨在调查孕期的寄生虫感染情况。我们比较了血清阴性母亲和血清阳转母亲的不良妊娠及婴儿健康结局。在289名接受孕期登革病毒暴露检测的参与者中，我们估计约有12名女性（4%）在妊娠期接触过登革病毒。然而，我们发现有34名母亲（11.8%）在孕期接触过登革病毒。这些母亲在孕期均未因严重登革病毒感染而住院，这表明许多人可能经历了无症状的血清阳转。社会经济地位、教育水平、蚊帐使用情况和母亲年龄等人口统计学风险因素与孕期轻度或无症状登革病毒感染无关。尽管孕期轻度或无症状登革病毒感染与晚期早产、出生后儿童发育指标降低或不良母亲妊娠结局无关，但我们观察到低出生体重风险增加。在这个肯尼亚沿海队列中，孕期登革病毒感染的负担高于预期，且观察到存在低出生体重的潜在风险，这为开展更全面的研究以充分了解孕期登革病毒感染提供了证据。
