Dengue Virus Infection in Pregnancy during the 2023 and 2024 Dengue Outbreaks in Peru: A Retrospective Review in a Tertiary Referral Center

Dengue, a major mosquito-borne viral disease, represents a public health threat in tropical regions. Its impact on pregnancy remains unclear, with limited data on maternal and perinatal outcomes. To describe the clinical, demographic, laboratory, and management characteristics of dengue during pregnancy, we conducted a retrospective review of medical records. We included adult pregnant women with confirmed dengue infection admitted to a referral hospital in Peru from March 2023 to July 2024. Cases were classified using the WHO criteria. Fifty-four cases were identified, of which 63% had dengue without warning signs, 35% had warning signs, and 2% had severe dengue. The mean age was 28 ± 7 years old. On admission, fever was the most common symptom (96%) followed by headache (67%) and abdominal pain (63%). Most women (92%) had lymphopenia, with 40% presenting severe lymphopenia. Anemia was found in 24% of cases. Most patients had normal platelet counts (83%) and normal transaminases (77%). Leukopenia and leukocytosis were present in 34% and 17% of patients, respectively. The mean length of hospitalization was 6 ± 2 days, with five patients requiring intensive care unit admission. Reported complications included pleural effusion, ascites, and pericardial effusion. Regarding obstetric outcomes, seven cases of miscarriage and three premature births were reported. In our study, dengue in pregnancy frequently presented with warning signs; however, most patients did not progress to severe dengue. The miscarriage rate during the index hospitalization and the occurrence of preterm birth highlight the potential risks of dengue in this population.