Dengue in Pregnancy A Systemic Review and Meta analysis of Maternal and Perinatal Outcomes

Background: Dengue fever, a mosquito-borne viral infection, is a growing concern for maternal and fetal health in endemic regions, particularly in South Asia. Dengue infection during pregnancy poses serious risks, yet comprehensive data on its impact remains limited. Objective: This study aims to evaluate the maternal, fetal, and neonatal outcomes associated with dengue infection in pregnant women based on evidence from ten South Asian studies. Methods: A systematic analysis was conducted across ten studies involving 1,956 pregnant women with confirmed dengue infection through NS1 antigen and/or IgM antibody testing. The pooled prevalence of maternal and neonatal complications was calculated, with statistical significance determined at a p-value of <0.05. Results: Postpartum hemorrhage was the most prevalent maternal complication, affecting 3.02% of cases. Additionally, 1.02% of infected women required ICU admission, and the maternal mortality rate was 0.51%. Other maternal complications included hypertensive disorders (0.46%), acute kidney injury (0.41%), and acute respiratory distress syndrome (0.36%). Fetal and neonatal complications were also notable, with preterm birth occurring in 3.63% of cases, low birth weight in 2.76%, and NICU/SNCU admission in 2.15%. Adverse outcomes, such as stillbirth/intrauterine death (1.02%) and miscarriage (0.72%), were also observed, with 0.61% of cases showing evidence of vertical transmission. Conclusion: Dengue infection during pregnancy is associated with significant maternal and fetal/neonatal risks, including postpartum hemorrhage, preterm birth, and pregnancy loss. This analysis underscores the need for vigilant monitoring, early diagnosis, and intervention in pregnant women with dengue to improve outcomes. Further research is warranted to develop standardized protocols for managing dengue in pregnancy and to explore preventive measures in endemic areas.