Prevalência de infecção pelos vírus dengue em parturientes e neonatos, Goiânia-Goiás, 2009-2010

• Autor(a) principal: Argolo, Angela Ferreira Lopes de Teive e
• Data de Publicação: 2010
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/4210
• topic: Dengue; Prevalência; Incidência; Gravidez; Recém-nascidos; Transmissão vertical; Prevalence; Incidence; Pregnancy; Neonates; Vertical transmission; CIENCIAS DA SAUDE::MEDICINA

The research about the epidemiology and the pathogeneses of dengue virus during the gestational period is essential to the understanding of clinical dengue severity among women and their offspring. It has been postulated that children born from women with antidengue antibodies may develop severe dengue during the first viral dengue exposure. The objectives were (a) to determine the prevalence and incidence of dengue infection in pregnant women and their neonates in two public hospitals in the city of Goiania, Goias State, Central Brazil, (b) to assess the percent of newborns with maternal IgG and DENV vertical transmission, (c) to evaluate the association of maternal recent dengue infection (IgM) with the characteristics of the delivery and neonates. A cross sectional study was conducted to assess recent (IgM) and previous (IgG) markers of dengue infection among pregnant women and newborns. The survey was conducted in two public hospitals in the city of Goiania (~1.2 million inhabitants), Central Brazil, from December 2009 to May 2010. We recruited women after giving birth. Women were interviewed to collect data about previous dengue infection, symptoms of dengue during gestational period, pregnancy period, delivery mode and outcomes pregnancy. Blood samples were collected from women and neonates (umbilical cord). Previous infection was defined by the positivity to IgG serology (PAN BIO) and recent infection by IgM (PAN BIO). The detection of NS1Ag and viral nucleic acid (RT-PCR) were performed in the subsample of participants who reported specific symptoms of dengue fever ten days previous to the delivery time. Prevalence and incidence estimates were calculated with 95% Confidence Intervals (95% CI). The agreement between the positive and negative serological results of the pair of women and their concepts was calculated (Kappa Index). Positive and Negative Predictive values between the history of previous dengue and the results of serological markers were calculated. A case-control analysis was performed to assess risk factors among IgM positive women (cases) and the outcomes of pregnancy compared to the seronegative women (controls). Analysis was performed using SPSS 17.0 e o Epi Info 6.04. The investigation was approved by the regional Ethical Committee and all participants signed informed consent according to the Brazilian regulation. A total of 505 women and 505 neonates were investigated. The mean age of women was 25.8 (SD = 6.4), 83.6% of ABSTRACT xv deliveries were between 37 and 41 weeks of pregnancy. The prevalence of IgG dengue antibody was 53.9% (95% IC 49.3% - 58.0%) among women. Maternal antibodies were also found in 99.2% of the offspring (Kappa index = 0.96). NS1 antigen was negative among women and one case of DENV-2 was detected. The incidence of recent dengue infection (IgM positivity and RT-PCR) was 8.9% (95% CI 6.6% - 11.8%) among women and 1.6% (95% IC 0.7%-3.2%) among children. Eight neonates had IgM antibodies with evidence of vertical DENV transmission. The positive predictive value of the previous history of dengue related to seropositivity (IgG) was 88%. The outcomes of pregnancy were similar among seropositive and seronegative women in the case-control analysis. In our setting, half of the pregnant women had dengue antibodies. There was high agreement rates between the serological markers detected among the pair of women and their concepts. Acute dengue infection among pregnant women was not associated with the outcomes unfavorable of pregnancies.