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Perinatal outcomes of symptomatic chikungunya, dengue and Zika infection during pregnancy in Brazil: a registry-based cohort study
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Perinatal outcomes of symptomatic chikungunya, dengue and Zika infection during pregnancy in Brazil: a registry-based cohort study
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Journal Article
Perinatal outcomes of symptomatic chikungunya, dengue and Zika infection during pregnancy in Brazil: a registry-based cohort study
2025
Overview
The previous literature shows mixed conclusions regarding the risk of adverse perinatal outcomes in pregnant women with symptomatic chikungunya, dengue, and Zika. We investigated this topic using a linked population-based Brazilian cohort from 2015 to 2020. The study included 6,993,395 live births. Among these, 6066 ( < 0.1%) mothers were notified with chikungunya during pregnancy, 19,022 (0.3%) with dengue, and 8396 (0.1%) with Zika. Symptomatic maternal chikungunya was associated with an increased risk of preterm birth (Hazard ratio: 1.10, 95%CI 1.01-1.22), low Apgar score 5’ (1.44, 1.14-1.82), and neonatal death (1.50, 1.15-1.96). Symptomatic maternal dengue was associated with preterm birth (1.07, 1.02-1.12), low birth weight (1.10, 1.04-1.15), congenital anomalies (1.19, 1.03-1.37), and low Apgar score 5’ (1.26, 1.09-1.45). Symptomatic maternal Zika was associated with all adverse birth outcomes, particularly congenital anomalies, which were over twice the risk (2.36; 1.91-2.67) compared to the unexposed group. This study provides evidence of the adverse consequences of arbovirus infections during pregnancy, including critical time windows by trimester. Our findings emphasise the importance of implementing effective measures to prevent chikungunya, dengue, and Zika infections during pregnancy and the associated adverse birth and neonatal outcomes, which may have long-term health consequences for mothers and their children.
In this study of ~7 million Brazilian births, the authors show that chikungunya, dengue, or Zika infection during pregnancy is associated with an increased risk of adverse perinatal outcomes, with the magnitude of these effects varying by trimester of exposure.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 692/499
/ Adult
/ Chikungunya Fever - complications
/ Chikungunya Fever - epidemiology
/ Chikungunya Fever - virology
/ Congenital Abnormalities - epidemiology
/ Female
/ Humanities and Social Sciences
/ Humans
/ Neonates
/ Pregnancy Complications, Infectious - epidemiology
/ Pregnancy Complications, Infectious - virology
/ Pregnancy Outcome - epidemiology
/ Premature Birth - epidemiology
/ Risk
/ Science
/ Zika Virus Infection - complications
