Adverse outcomes and associations of dengue in pregnancy – a retrospective cohort study

Objective Dengue infection is a significant health issue in tropical areas over the globe. Physiological changes of pregnancy can be confounding the clinical presentation of dengue in pregnancy. This study aimed to investigate the adverse outcomes of antenatal dengue infection and factors associated with maternal, fetal, and neonatal complications. Methods A total of 115 pregnant women with laboratory-confirmed dengue infection admitted to two tertiary referral hospitals in Sri Lanka were followed from admission until delivery and discharge. Data on clinical and laboratory outcome variables were collected and analyzed using descriptive and inferential statistics. Results Dengue fever accounted for the majority of cases (63.5%), followed by dengue hemorrhagic fever (33.9%) and, dengue expanded syndrome (2.6%). Maternal adverse outcomes were observed in 27.8% of cases with 19.1% of ICU admissions. Dengue category, trimester of infection, platelet count, and AST levels showed a significant association with adverse maternal outcomes. Fetal adverse outcomes affected 8.1% of cases, while neonatal adverse outcomes occurred in 28.7% of live births, with transplacental transmission observed in two cases. Conclusion Dengue infection during pregnancy can lead to significant maternal, fetal, and neonatal morbidity and mortality. Identifying risk factors may help predict the severity of these outcomes. Further research is needed to develop robust prediction models and improve management strategies.