title: Symptomatic Dengue infection during pregnancy and infant outcomes: a retrospective cohort study.
abstract: BACKGROUND
  Dengue is a mosquito-borne disease that is common in many tropical and subtropical areas. Dengue infections can occur at any age and time in the lifespan, including during pregnancy. Few large scale studies have been conducted to determine the risk of preterm birth (PTB) and low birthweight (LBW) for infants born to women who had symptomatic dengue infection during pregnancy.
  
  
  RESULTS
  This study is a retrospective cohort study using medical records from 1992-2010 from pregnant women who attended a public regional referral hospital in western French Guiana. Exposed pregnancies were those with laboratory confirmed cases of dengue fever during pregnancy. Each of the 86 exposed infants was matched to the three unexposed births that immediately followed them to form a stratum. Conditional logistic regression was used to analyze these matched strata. Three groups were examined: all infants regardless of gestational age, only infants> = 17 weeks of gestational age and their strata, and only infants> = 22 weeks of age and their strata. Odds ratios were adjusted (aOR) for maternal age, maternal ethnicity, maternal gravidity, interpregnancy interval and maternal anemia. There was an increased risk of PTB among women with symptomatic dengue; (aOR all infants: 3.34 (1.13, 9.89), aOR 17 weeks: 1.89 (0.61, 5.87), aOR 22 weeks: 1.41 (0.39, 5.20)) but this risk was only statistically significant when all infants were examined (p value = 0.03). Adjusted results for LBW were similar, with an increased risk in the exposed group (aOR All infants: 2.23 (1.01, 4.90), aOR 17 weeks: 1.67 (0.71, 3.93), aOR 22 weeks: 1.43 (0.56, 3.70)) which was only statistically significant when all infants were examined (p value = 0.05).
  
  
  CONCLUSIONS
  Symptomatic dengue infection during pregnancy may increase the risk of PTB and LBW for infants. More research is needed to confirm these results and to examine the role of dengue fever in miscarriage.
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America.
authors.forename: Eleanor E
authors.initials: EE
authors.lastname: Friedman
authors.affiliation: Franck Joly Hospital, St. Laurent du Maroni, French Guiana, France.
authors.forename: Fadi
authors.initials: F
authors.lastname: Dallah
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America.
authors.forename: Emily W
authors.initials: EW
authors.lastname: Harville
authors.affiliation: Department of Biostatistics and Bioinformatics, Tulane School of Public Health and Tropical Medicine, New Orleans Louisiana, United States of America.
authors.forename: Leann
authors.initials: L
authors.lastname: Myers
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America.
authors.forename: Pierre
authors.initials: P
authors.lastname: Buekens
authors.affiliation: INSERM, U1153, Paris, France.
authors.forename: Gerard
authors.initials: G
authors.lastname: Breart
authors.affiliation: Franck Joly Hospital, St. Laurent du Maroni, French Guiana, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Carles
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003715:Dengue / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D047928:Premature Birth / Q000209:etiology*; D012189:Retrospective Studies