Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/25499
Title: Symptomatic dengue infection during pregnancy and the risk of stillbirth in Brazil, 2006–12: a matched case-control study
Authors: Paixão, Enny Santos da
Costa, Maria da Conceição Nascimento
Teixeira, Maria Glória Lima Cruz
Harron, Katie
Almeida, Marcia Furquim de
Barreto, Maurício Lima
Rodrigues, Laura Cunha
Affilliation: London School of Hygiene & Tropical Medicine. London, UK / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. London, UK.
Universidade de São Paulo. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Salvador, BA, Brasil / Universidade de São Paulo. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Salvador, BA, Brasil.
Abstract: Background Maternal infections during pregnancy can increase the risk of fetal death. Dengue infection is common, but little is known about its role in fetal mortality. We aimed to investigate the association between symptomatic dengue infection during pregnancy and fetal death. Methods We did a nested case-control study using obstetrician-collected data from the Brazilian livebirth information system (SINASC), the mortality information system (SIM), and the national reportable disease information system (SINAN). We identified all pregnancies ending in stillbirth and a random sample of livebirths between Jan 1, 2006, and Dec 31, 2012. We did linkage to determine which mothers were diagnosed with dengue infection during pregnancy. By use of stillbirths as cases and a sample of matched livebirths as a control, we calculated matched odds ratios (mORs) using conditional logistic regression adjusted for maternal age and education. Findings 275 (0·2%) of 162 188 women who had stillbirths and 1507 (0·1%) of 1 586 105 women who had livebirths were diagnosed with dengue infection during pregnancy. Symptomatic dengue infection during pregnancy almost doubled the odds of fetal death (mOR 1·9, 95% CI 1·6–2·2). The increase in risk was similar when analyses were restricted to laboratory-confirmed cases of dengue infection (1·8, 1·4–2·4). Severe dengue infection increased the risk of fetal death by about five times (4·9, 2·3–10·2). Interpretation Symptomatic dengue infection during pregnancy is associated with an increased risk of fetal death. We recommend further epidemiological and biological studies of the association between dengue and poor birth outcomes to measure the burden of subclinical infections and elucidate pathological mechanisms.
Keywords: Dengue
Dengue Virus Infection
Pregnancy
Fetal death
Risk factors
Humans
Female
Stillbirths
keywords: Dengue
Infecção pelo Vírus da Dengue
Gravidez
Morte fetal
Fatores de risco
Humanos
Feminino
Natimortos
Issue Date: 2017
Publisher: Elsevier
Citation: PAIXÃO, Enny Santos da et al. Symptomatic dengue infection during pregnancy and the risk of stillbirth in Brazil, 2006–12: a matched case-control study. Lancet Infectious Diseases, v. 17, p. 957–964, 2017.
DOI: 10.1016/S1473-3099(17)30366-3
ISSN: 1473-3099
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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