{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:09:52Z","timestamp":1780499392554,"version":"3.54.1"},"reference-count":124,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Many infectious diseases are known to have increased severity among pregnant people, yet limited data exist on the burden of dengue in this population. This systematic review collated studies conducted from 2010 onward to capture epidemiological data and a variety of pregnancy outcomes of those infected with dengue during gestation. Among the 23 included publications, dengue infections in pregnant individuals were most frequently contracted in the third trimester. Dengue-infected mothers appear to be associated with a higher risk of maternal mortality (0\u201321.7%), pregnancy loss (0\u201311.6%), and preterm birth (4.3\u201337.5%) compared with healthy mothers. However, heterogeneity of data, missing quantitative comparisons of outcomes in dengue-positive and dengue-negative pregnant people, and lack of standardization of study methods and measurement emphasize an evidence gap. As dengue infections continue to rise and transmission boundaries expand, it is imperative to include pregnant people in dengue studies, surveillance, and public health measures.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0311","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T18:09:04Z","timestamp":1776794944000},"page":"1032-1043","source":"Crossref","is-referenced-by-count":0,"title":["Burden of Dengue in Pregnant Individuals: A Systematic Literature Review"],"prefix":"10.4269","volume":"114","author":[{"given":"Rada","family":"Rusu","sequence":"first","affiliation":[{"name":"Johnson & Johnson, Toronto, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Durbin","sequence":"additional","affiliation":[{"name":"John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Clements","sequence":"additional","affiliation":[{"name":"Costello Medical Consulting Ltd, Manchester, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Frost","sequence":"additional","affiliation":[{"name":"Costello Medical Consulting Ltd, Cambridge, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Mariner-Goff","sequence":"additional","affiliation":[{"name":"Costello Medical Consulting Ltd, Cambridge, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Massey","sequence":"additional","affiliation":[{"name":"Costello Medical Singapore Pte Ltd, Singapore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Murton","sequence":"additional","affiliation":[{"name":"Costello Medical Consulting Ltd, Cambridge, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley V.","family":"Sylvester","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"About Dengue.","year":"2024"},{"key":"b2","article-title":"Dengue and Severe Dengue.","year":"2024"},{"issue":"9","key":"b3","series-title":"Nat Microbiol","first-page":"1508","article-title":"The current and future global distribution and population at risk of dengue","volume":"4","author":"Messina","year":"2019"},{"key":"b4","article-title":"Symptoms of Dengue and Testing.","year":"2024"},{"key":"b5","series-title":"Dengue Fever","author":"Schaefer","year":"2024"},{"issue":"15","key":"b6","series-title":"Sci Immunol","first-page":"eaan2946","article-title":"An immune clock of human pregnancy","volume":"2","author":"Aghaeepour","year":"2017"},{"key":"b7","article-title":"Infections in Pregnancy.","author":"Cherney","year":"2016"},{"issue":"11","key":"b8","series-title":"Cureus","first-page":"e48640","article-title":"A narrative review of maternal and perinatal outcomes of dengue in pregnancy","volume":"15","author":"Ahuja","year":"2023"},{"issue":"2","key":"b9","series-title":"Trop Med Int Health","first-page":"153","article-title":"Dengue epidemics and adverse obstetrical outcomes in French Guiana: A semi-ecological study","volume":"19","author":"Hanf","year":"2014"},{"issue":"9","key":"b10","series-title":"Lancet Infect Dis","first-page":"957","article-title":"Symptomatic dengue infection during pregnancy and the risk of stillbirth in Brazil, 2006\u201312: A matched case-control study","volume":"17","author":"Paix\u00e3o","year":"2017"},{"issue":"2","key":"b11","series-title":"Trop Med Infect Dis","first-page":"86","article-title":"Dengue in pregnancy: A Southeast Asian perspective","volume":"8","author":"Chong","year":"2023"},{"issue":"10","key":"b12","series-title":"J Med Ethics","first-page":"657","article-title":"Vulnerability of pregnant women in clinical research","volume":"43","author":"van der Zande","year":"2017"},{"issue":"10419","key":"b13","series-title":"Lancet","first-page":"2346","article-title":"The 2023 report of the Lancet Countdown on health and climate change: The imperative for a health-centred response in a world facing irreversible harms","volume":"402","author":"Romanello","year":"2023"},{"key":"b14","article-title":"Cochrane Handbook for Systematic Reviews of Interventions (Current Version).","author":"Higgins","year":"2024"},{"key":"b15","series-title":"BMJ","first-page":"n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021"},{"key":"b16","article-title":"Our Guidance, Systematic Reviews: CRD\u2019s Guidance for Undertaking Reviews in Health Care","year":"2008"},{"key":"b17","article-title":"Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields.","author":"Kmet","year":"2004"},{"key":"b18","series-title":"Virol J","first-page":"153","article-title":"Maternal and perinatal outcomes of dengue in PortSudan, Eastern Sudan","volume":"7","author":"Adam","year":"2010"},{"key":"b19","series-title":"Revista Cubana de Obstetricia y Ginecolog\u00eda","first-page":"42","article-title":"Repercusi\u00f3n del dengue serotipo 3 sobre el embarazo y producto de la concepci\u00f3n","volume":"36","author":"L\u00f3pez Barroso","year":"2010"},{"issue":"1","key":"b20","series-title":"Arch Gynecol Obstet","first-page":"91","article-title":"Maternal and fetal outcomes of dengue fever in pregnancy: A large prospective and descriptive observational study","volume":"304","author":"Brar","year":"2021"},{"issue":"6","key":"b21","series-title":"J South Asian Federation Obstet Gynaecol","first-page":"412","article-title":"Maternal and perinatal outcome in dengue fever in pregnancy in North India","volume":"13","author":"Garg","year":"2022"},{"issue":"3","key":"b22","series-title":"J Cardiovasc Dis Res","first-page":"967","article-title":"To investigate the maternal and foetal consequences of dengue fever in pregnant women","volume":"14","author":"Kaur","year":"2023"},{"issue":"3","key":"b23","series-title":"Korean J Fam Med","first-page":"161","article-title":"Maternal and neonatal outcomes during dengue infection outbreak at a tertiary national hospital in endemic area of Indonesia","volume":"41","author":"Mulyana","year":"2020"},{"issue":"4","key":"b24","series-title":"J South Asian Federation Obstet Gynaecol","first-page":"251","article-title":"Clinical study on spectrum of dengue morbidity in pregnancy and its impact","volume":"13","author":"Muralidhar","year":"2021"},{"key":"b25","series-title":"J Clin Virol","first-page":"104758","article-title":"Clinical features and outcomes of neonatal dengue at the Children\u2019s Hospital 1, Ho Chi Minh, Vietnam","volume":"138","author":"Nguyen","year":"2021"},{"key":"b26","series-title":"Determining Impact of Dengue Virus Infection in Pregnancy on Maternal and Child Outcomes","author":"Smith","year":"2023"},{"issue":"10","key":"b27","series-title":"PLoS One","first-page":"e0202005","article-title":"A prospective matched study on symptomatic dengue in pregnancy","volume":"13","author":"Basurko","year":"2018"},{"issue":"4","key":"b28","series-title":"PLoS Negl Trop Dis","first-page":"e0004577","article-title":"The aetiologies and impact of fever in pregnant inpatients in Vientiane, Laos","volume":"10","author":"Chansamouth","year":"2016"},{"issue":"10","key":"b29","series-title":"PLoS Negl Trop Dis","first-page":"e3226","article-title":"Symptomatic dengue infection during pregnancy and infant outcomes: A retrospective cohort 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of Interventions","first-page":"i","year":"2019"},{"issue":"2","key":"b62","series-title":"Obstet Gynecol Surv","first-page":"107","article-title":"Maternal dengue and pregnancy outcomes: A systematic review","volume":"65","author":"Pouliot","year":"2010"},{"key":"b1","article-title":"About Dengue.","year":"2024"},{"key":"b2","article-title":"Dengue and Severe Dengue.","year":"2024"},{"issue":"9","key":"b3","series-title":"Nat Microbiol","first-page":"1508","article-title":"The current and future global distribution and population at risk of dengue","volume":"4","author":"Messina","year":"2019"},{"key":"b4","article-title":"Symptoms of Dengue and Testing.","year":"2024"},{"key":"b5","series-title":"Dengue Fever","author":"Schaefer","year":"2024"},{"issue":"15","key":"b6","series-title":"Sci Immunol","first-page":"eaan2946","article-title":"An immune clock of human pregnancy","volume":"2","author":"Aghaeepour","year":"2017"},{"key":"b7","article-title":"Infections in Pregnancy.","author":"Cherney","year":"2016"},{"issue":"11","key":"b8","series-title":"Cureus","first-page":"e48640","article-title":"A narrative review of maternal and perinatal outcomes of dengue in pregnancy","volume":"15","author":"Ahuja","year":"2023"},{"issue":"2","key":"b9","series-title":"Trop Med Int Health","first-page":"153","article-title":"Dengue epidemics and adverse obstetrical outcomes in French Guiana: A semi-ecological study","volume":"19","author":"Hanf","year":"2014"},{"issue":"9","key":"b10","series-title":"Lancet Infect Dis","first-page":"957","article-title":"Symptomatic dengue infection during pregnancy and the risk of stillbirth in Brazil, 2006\u201312: A matched case-control study","volume":"17","author":"Paix\u00e3o","year":"2017"},{"issue":"2","key":"b11","series-title":"Trop Med Infect Dis","first-page":"86","article-title":"Dengue in pregnancy: A Southeast Asian 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problem?","volume":"15","author":"Sinha","year":"2023"},{"issue":"9","key":"b38","series-title":"PLoS One","first-page":"e0238431","article-title":"Dengue virus infection and pregnancy outcomes during the 2017 outbreak in Ouagadougou, Burkina Faso: A retrospective cohort study","volume":"15","author":"Tougma","year":"2020"},{"issue":"4&5","key":"b39","series-title":"Indian J Med Res","first-page":"619","article-title":"Maternal & perinatal outcome of fever in pregnancy in the context of dengue\u2014A retrospective observational study","volume":"156","author":"Sagili","year":"2022"},{"key":"b40","series-title":"Biomed Res Int","first-page":"9643083","article-title":"Maternal, fetal, and neonatal outcomes in pregnant dengue patients in Mexico","volume":"2018","author":"Machain-Williams","year":"2018"},{"issue":"10450","key":"b41","series-title":"Lancet","first-page":"311","article-title":"Dengue: The threat to health now and in the future","volume":"404","year":"2024"},{"key":"b42","article-title":"Dengue Worldwide Overview.","year":"2024"},{"key":"b43","article-title":"In Record Year of Dengue Cases, PAHO Urges Countries to Strengthen Response as Seasonal Transmission Set to Begin in South America.","year":"2024"},{"key":"b44","article-title":"Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division.","year":"2023"},{"key":"b45","article-title":"EMRO-WHO Weekly Epidemiological Monitor Volume 10, Issue 49, 03 December 2017.","year":"2017"},{"issue":"23","key":"b46","series-title":"N Engl J Med","first-page":"2211","article-title":"Pregnancy and infection","volume":"370","author":"Kourtis","year":"2014"},{"issue":"12","key":"b47","series-title":"Biochim Biophys Acta Mol Basis Dis","first-page":"166244","article-title":"Significance of the placental barrier in antenatal viral 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Forgotten: The Situation of Stillbirth around the Globe.","year":"2023"},{"issue":"10302","key":"b53","series-title":"Lancet","first-page":"772","article-title":"Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: A systematic assessment","volume":"398","author":"Hug","year":"2021"},{"issue":"2","key":"b54","series-title":"J Obstet Gynaecol Res","first-page":"191","article-title":"Toll-like receptors and pregnancy: Trophoblast as modulators of the immune response","volume":"35","author":"Koga","year":"2009"},{"issue":"3","key":"b55","series-title":"Am J Reprod Immunol","first-page":"199","article-title":"Viral infections during pregnancy","volume":"73","author":"Silasi","year":"2015"},{"issue":"5","key":"b56","series-title":"J Clin Invest","first-page":"1591","article-title":"Risks associated with viral infections during 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