Dengue Infection and Miscarriage: a Prospective Case Control Study

Overview

Journal PLoS Negl Trop Dis

Specialties Infectious Diseases
Tropical Medicine

Date 2012 May 17

PMID 22590658

Citations 22

Authors

Peng Chiong Tan

May Zaw Soe

Khaing Si Lay

Seok Mui Wang

Shamala Devi Sekaran

Siti Zawiah Omar

Affiliations

Soon will be listed here.

Abstract

Background: Dengue is the most prevalent mosquito borne infection worldwide. Vertical transmissions after maternal dengue infection to the fetus and pregnancy losses in relation to dengue illness have been reported. The relationship of dengue to miscarriage is not known.

Method: We aimed to establish the relationship of recent dengue infection and miscarriage. Women who presented with miscarriage (up to 22 weeks gestation) to our hospital were approached to participate in the study. For each case of miscarriage, we recruited 3 controls with viable pregnancies at a similar gestation. A brief questionnaire on recent febrile illness and prior dengue infection was answered. Blood was drawn from participants, processed and the frozen serum was stored. Stored sera were thawed and then tested in batches with dengue specific IgM capture ELISA, dengue non-structural protein 1 (NS1) antigen and dengue specific IgG ELISA tests. Controls remained in the analysis if their pregnancies continued beyond 22 weeks gestation. Tests were run on 116 case and 341 control sera. One case (a misdiagnosed viable early pregnancy) plus 45 controls (39 lost to follow up and six subsequent late miscarriages) were excluded from analysis.

Findings: Dengue specific IgM or dengue NS1 antigen (indicating recent dengue infection) was positive in 6/115 (5·2%) cases and 5/296 (1·7%) controls RR 3·1 (95% CI 1·0-10) P = 0·047. Maternal age, gestational age, parity and ethnicity were dissimilar between cases and controls. After adjustments for these factors, recent dengue infection remained significantly more frequently detected in cases than controls (AOR 4·2 95% CI 1·2-14 P = 0·023).

Interpretation: Recent dengue infections were more frequently detected in women presenting with miscarriage than in controls whose pregnancies were viable. After adjustments for confounders, the positive association remained.

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References

Tan P, Rajasingam G, Devi S, Omar S . Dengue infection in pregnancy: prevalence, vertical transmission, and pregnancy outcome. Obstet Gynecol. 2008; 111(5):1111-7. DOI: 10.1097/AOG.0b013e31816a49fc. View

Guzman M, Halstead S, Artsob H, Buchy P, Farrar J, Gubler D . Dengue: a continuing global threat. Nat Rev Microbiol. 2010; 8(12 Suppl):S7-16. PMC: 4333201. DOI: 10.1038/nrmicro2460. View

McGready R, Ashley E, Wuthiekanun V, Oo Tan S, Pimanpanarak M, Viladpai-Nguen S . Arthropod borne disease: the leading cause of fever in pregnancy on the Thai-Burmese border. PLoS Negl Trop Dis. 2010; 4(11):e888. PMC: 2982829. DOI: 10.1371/journal.pntd.0000888. View

Dupont W, Plummer Jr W . Power and sample size calculations. A review and computer program. Control Clin Trials. 1990; 11(2):116-28. DOI: 10.1016/0197-2456(90)90005-m. View

Vinomarlini G, Rogayah T, Saraswathy T, Thayan R, Apandi M, Fauziah M . Molecular typing of dengue viruses circulating on the East Coast of Peninsular Malaysia from 2005 to 2009. Southeast Asian J Trop Med Public Health. 2011; 42(1):94-9. View

Seet R, Quek A, Lim E . Post-infectious fatigue syndrome in dengue infection. J Clin Virol. 2006; 38(1):1-6. DOI: 10.1016/j.jcv.2006.10.011. View

Gibbons R, Vaughn D . Dengue: an escalating problem. BMJ. 2002; 324(7353):1563-6. PMC: 1123504. DOI: 10.1136/bmj.324.7353.1563. View

Yabe S, Nakayama M, Yamada K, Kitano T, Arai Y, Horimoto T . [Laboratory virological diagnosis of imported dengue cases]. Kansenshogaku Zasshi. 1996; 70(11):1160-9. DOI: 10.11150/kansenshogakuzasshi1970.70.1160. View

Garcia G, Gonzalez N, Perez A, Sierra B, Aguirre E, Rizo D . Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders. Int J Infect Dis. 2010; 15(1):e38-43. DOI: 10.1016/j.ijid.2010.09.008. View

10.

Mohamed Ismail N, Kampan N, Mahdy Z, Jamil M, Mohd Razi Z . Dengue in pregnancy. Southeast Asian J Trop Med Public Health. 2006; 37(4):681-3. View

11.

Hu D, Di B, Ding X, Wang Y, Chen Y, Pan Y . Kinetics of non-structural protein 1, IgM and IgG antibodies in dengue type 1 primary infection. Virol J. 2011; 8:47. PMC: 3045343. DOI: 10.1186/1743-422X-8-47. View

12.

Waduge R, Malavige G, Pradeepan M, Wijeyaratne C, Fernando S, Seneviratne S . Dengue infections during pregnancy: a case series from Sri Lanka and review of the literature. J Clin Virol. 2006; 37(1):27-33. DOI: 10.1016/j.jcv.2006.06.002. View

13.

Adam I, Jumaa A, Elbashir H, Karsany M . Maternal and perinatal outcomes of dengue in PortSudan, Eastern Sudan. Virol J. 2010; 7:153. PMC: 2911427. DOI: 10.1186/1743-422X-7-153. View

14.

Pouliot S, Xiong X, Harville E, Paz-Soldan V, Tomashek K, Breart G . Maternal dengue and pregnancy outcomes: a systematic review. Obstet Gynecol Surv. 2010; 65(2):107-18. DOI: 10.1097/OGX.0b013e3181cb8fbc. View

15.

Nogueira R, Miagostovich M, Cavalcanti S, Marzochi K, Schatzmayr H . Levels of IgM antibodies against dengue virus in Rio de Janeiro, Brazil. Res Virol. 1992; 143(6):423-7. DOI: 10.1016/s0923-2516(06)80136-6. View

16.

Chakravarti A, Arora R, Luxemburger C . Fifty years of dengue in India. Trans R Soc Trop Med Hyg. 2012; 106(5):273-82. DOI: 10.1016/j.trstmh.2011.12.007. View

17.

Azami N, Salleh S, Neoh H, Syed Zakaria S, Jamal R . Dengue epidemic in Malaysia: Not a predominantly urban disease anymore. BMC Res Notes. 2011; 4:216. PMC: 3154160. DOI: 10.1186/1756-0500-4-216. View

18.

Basurko C, Carles G, Youssef M, Guindi W . Maternal and fetal consequences of dengue fever during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2009; 147(1):29-32. DOI: 10.1016/j.ejogrb.2009.06.028. View

19.

de Paula S, da Fonseca B . Dengue: a review of the laboratory tests a clinician must know to achieve a correct diagnosis. Braz J Infect Dis. 2005; 8(6):390-8. DOI: 10.1590/s1413-86702004000600002. View

20.

Fernandez R, Rodriguez T, Borbonet F, Vazquez S, Guzman M, Kouri G . [Study of the relationship dengue-pregnancy in a group of cuban-mothers]. Rev Cubana Med Trop. 1994; 46(2):76-8. View