title: Dengue epidemics and adverse obstetrical outcomes in French Guiana: a semi-ecological study.
abstract: OBJECTIVE
  To determine whether dengue epidemics are associated with an increase in adverse obstetrical outcomes.
  
  
  METHODS
  Semi-ecological study combining individual data on obstetrical events from the perinatal registry and aggregated exposure data from the epidemiologic surveillance of dengue in Cayenne, French Guiana between 2004 and 2007.
  
  
  RESULTS
  After adjustment for individual risk factors, analysis showed that an epidemic level of dengue transmission during the first trimester was associated with an increased risk of post-partum haemorrhage and preterm birth. The associated risks seemed to depend on the epidemic level.
  
  
  CONCLUSIONS
  Despite its limitations, this study suggests that dengue in the first trimester may be related to preterm birth and to post-partum bleeding, thus leading to specific hypotheses that should be tested in prospective studies.
authors.affiliation: Centre d'Investigation Clinique Epidemiologie Clinique Antilles Guyane, inserm CIE802, Centre Hospitalier de Cayenne, Cayenne, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Hanf
authors.forename: Eleanor
authors.initials: E
authors.lastname: Friedman
authors.forename: Celia
authors.initials: C
authors.lastname: Basurko
authors.forename: Amaury
authors.initials: A
authors.lastname: Roger
authors.forename: Pascal
authors.initials: P
authors.lastname: Bruncher
authors.forename: Philippe
authors.initials: P
authors.lastname: Dussart
authors.forename: Claude
authors.initials: C
authors.lastname: Flamand
authors.forename: Gabriel
authors.initials: G
authors.lastname: Carles
authors.forename: Pierre
authors.initials: P
authors.lastname: Buekens
authors.forename: Gerard
authors.initials: G
authors.lastname: Breart
authors.forename: Bernard
authors.initials: B
authors.lastname: Carme
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
mesh_terms: D003715:Dengue / Q000150:complications* / Q000453:epidemiology; D003716:Dengue Virus; D058872:Epidemics; D005260:Female; D005616:French Guiana / Q000453:epidemiology; D006801:Humans; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence
keywords: French Guiana; Post-partum haemorrhage; dengue fever; pregnancy; preterm birth