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Exposure to Dengue Virus During Pregnancy: Incidence and Impact on Maternal and Child Outcomes

Annabelle Smith Stanford Medicine, Stanford University, Stanford, California;

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Bethel Alebel Bayrau Stanford Medicine, Stanford University, Stanford, California;

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Caroline Ichura Stanford Medicine, Stanford University, Stanford, California;

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Jonathan Altamirano Stanford Medicine, Stanford University, Stanford, California;

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Charles King Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio;

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Indu Malhotra Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio;

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Peter Mungai Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio;

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Francis Mutuku Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya

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Dunstan Mukoko Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya

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A. Désirée LaBeaud Stanford Medicine, Stanford University, Stanford, California;

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DOI:
https://doi.org/10.4269/ajtmh.24-0387
Volume/Issue:
Ahead of Print
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Dengue virus (DENV) is the most common arbovirus globally, with its incidence growing dramatically in recent decades. Although the effects of DENV infection during pregnancy are unclear, reported associations with adverse health outcomes include miscarriage, prematurity, and low birth weight. In this study, we used an IgG ELISA to identify mothers exposed to DENV during pregnancy by testing samples obtained from a previous study that followed a cohort of pregnant women in Kenya to investigate parasitic infections during pregnancy. We compared adverse pregnancy and infant health outcomes between seronegative mothers and those who seroconverted. Of the 289 participants tested for DENV exposure during pregnancy, we estimated that ∼12 women (4%) would have been exposed to DENV during their gestation period. However, we found that 34 mothers (11.8%) had been exposed to DENV during pregnancy. None of these mothers were hospitalized during pregnancy because of severe DENV infection, suggesting that many may have undergone asymptomatic seroconversion. The demographic risk factors of socioeconomic status, education level, bed net use, and maternal age were not associated with mild or asymptomatic DENV in pregnancy. Although mild or asymptomatic DENV during pregnancy was not associated with late prematurity, reduced postnatal childhood developmental measures, or adverse maternal pregnancy outcomes, we observed an increased risk of low birth weight. The larger-than-expected burden of DENV in pregnancy in this coastal Kenyan cohort and the observed potential risk of low birth weight provide evidence that a more comprehensive study is warranted to fully understand DENV infection during pregnancy.

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Author Notes

Financial support: Funding for the original study was initially provided through grant OPP1066865 “Enhancing Infant Immunity: Effect of Early Maternal Treatment for Parasitic Infections” to C. King from the Bill and Melinda Gates Foundation. Funding for this study was provided through NIH R01 grant AI102918 to A. D. LaBeaud.

Current contact information: Annabelle Smith, Bethel Alebel Bayrau, Caroline Ichura, Jonathan Altamirano, and A. Désirée LaBeaud, Stanford Medicine, Stanford University, Stanford, CA, E-mails: ads12@alumni.stanford.edu, bethel7@stanford.edu, ichuracw@stanford.edu, altamira@stanford.edu, and dlabeaud@stanford.edu. Charles King, Indu Malhotra, and Peter Mungai, Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, E-mails: chk@case.edu, ijm@case.edu, and plmungai@yahoo.com. Francis Mutuku and Dunstan Mukoko, Technical University of Mombasa, Mombasa, Kenya, E-mails: fmutuku73@gmail.com and dunstan.mukoko29@gmail.com.

Address correspondence to Annabelle Smith, National Institutes of Health, 4 Memorial Dr., Building 4, Rm B1-05, Bethesda, MD 20814. E-mail: ads12@alumni.stanford.edu
Copyright:
© American Society of Tropical Medicine and Hygiene 2024
Received:
12 Jun 2024
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Accepted:
03 Sep 2024
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Published Online:
03 Dec 2024
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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