{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:08:21Z","timestamp":1787317701877,"version":"build-2736575974"},"reference-count":117,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Facultad de Ciencias M\u00e9dicas","award":["2-03-01-01"],"award-info":[{"award-number":["2-03-01-01"]}]},{"name":"Universidad Nacional Autonoma de Honduras (UNAH), Tegucigalpa, MDC, Honduras, Central America"},{"id":[{"id":"https:\/\/ror.org\/03xyve152","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Ministerio de Ciencia, Tecnolog\u00eda e Innovaci\u00f3n","award":["91903"],"award-info":[{"award-number":["91903"]}]},{"award":["91903"],"award-info":[{"award-number":["91903"]}],"id":[{"id":"https:\/\/ror.org\/02h503d38","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Yellow fever remains a major public health threat in endemic and re-emerging regions of Africa and South America, with recent outbreaks highlighting persistent gaps in prevention and surveillance. Pregnant women represent a particularly vulnerable population, yet the epidemiology, clinical impact, and preventive strategies for yellow fever in pregnancy are insufficiently characterized. Physiological and immunological changes during gestation may influence host responses to infection; however, current evidence does not demonstrate increased susceptibility to or severity of yellow fever during pregnancy. Adverse materno-fetal outcomes, including miscarriage, stillbirth, preterm birth, and, in rare cases, perinatal transmission, have been reported but remain poorly characterized. Diagnostic challenges, overlapping clinical presentations with other arboviral and hepatic diseases, and limited access to specialized care further complicate clinical management in many endemic settings. This perspective provides a comprehensive overview of yellow fever in pregnancy during the 2024\u20132026 outbreak in the Americas, including a risk-stratification framework for prevention. We summarize current evidence on epidemiology, pathophysiology, diagnosis, and supportive care, and examine prevention strategies with particular emphasis on vaccination. Accumulated observational evidence and substantial real-world experience have not demonstrated an increased risk of serious adverse events and generally support the effectiveness of yellow fever vaccination during pregnancy when administered with appropriate clinical judgment. In high-risk settings, the benefits of maternal immunization clearly outweigh theoretical concerns, supporting a flexible, risk-based approach, despite relatively limited evidence. We also discuss national and international policies, post-pregnancy booster recommendations, and the importance of integrating vaccination assessment into antenatal care. Finally, we highlight critical knowledge gaps and research priorities, including the need for prospective registries and strengthened pharmacovigilance. Coordinated clinical and public health strategies are essential to protect maternal and neonatal health and to reduce the burden of yellow fever in endemic and re-emerging settings.<\/jats:p>","DOI":"10.3390\/tropicalmed11040092","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:41:53Z","timestamp":1774878113000},"page":"92","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Yellow Fever in Pregnancy: A Comprehensive Review of the Clinical Implications and Vaccination in the Context of the 2024\u20132026 Americas Outbreak"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9773-2192","authenticated-orcid":false,"given":"Alfonso J.","family":"Rodr\u00edguez-Morales","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15067, Peru"},{"name":"Grupo de Investigaci\u00f3n Biomedicina, Faculty of Medicine, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas-Instituci\u00f3n Universitaria Visi\u00f3n de las Am\u00e9ricas, Pereira 660003, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9268-5753","authenticated-orcid":false,"given":"Katherine","family":"Acevedo-Jimenez","sequence":"additional","affiliation":[{"name":"Program of Family Medicine Specialization, Faculty of Medicine, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas-Instituci\u00f3n Universitaria Visi\u00f3n de las Am\u00e9ricas, Pereira 660003, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Eugenia","family":"Guevara","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad Centro-Occidental Lisandro Alvarado, Barquisimeto 3001, 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X.","family":"Olaya","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Biomedicina, Faculty of Medicine, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas-Instituci\u00f3n Universitaria Visi\u00f3n de las Am\u00e9ricas, Pereira 660003, Colombia"},{"name":"Gynecology, Clinica Comfamiliar, Pereira 660001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio David","family":"Angulo","sequence":"additional","affiliation":[{"name":"Gynecology, Clinica Comfamiliar, Pereira 660001, Colombia"},{"name":"Research and Teaching Unit, Salud Comfamiliar, Pereira 660001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime A.","family":"Cardona-Ospina","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Biomedicina, Faculty of Medicine, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas-Instituci\u00f3n Universitaria Visi\u00f3n de las Am\u00e9ricas, Pereira 660003, 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