Moderation effects of serotype on dengue severity across pregnancy status in Mexico

Annan E 1 , Nguyen UDT 2 , Treviño J 3 , Wan Yaacob WF 4 , Mangla S 5 , Pathak AK 6 Show all authors , Nandy R 2 , Haque U 7

Affiliations 

  • 1 Department of Biostatistics & Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA. esther.annan@princeton.edu
  • 2 Department of Biostatistics & Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
  • 3 Department of Urban Affairs at the School of Architecture, Universidad Autónoma de Nuevo León, 66455, San Nicolás de los Garza, Nuevo Léon, México
  • 4 Mathematical Sciences Studies, College of Computing, Informatics and Media, Universiti Teknologi MARA Cawangan Kelantan, Lembah Sireh, Kampus Kota Bharu, 15150, Kota Bharu, Kelantan, Malaysia
  • 5 International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
  • 6 Department of Mathematics and Statistics, Central University of Punjab, Bathinda, Punjab, 151401, India
  • 7 Rutgers Global Health Institute, New Brunswick, NJ, USA
BMC Infect Dis, 2023 Mar 10;23(1):147.
PMID: 36899304 DOI: 10.1186/s12879-023-08051-z

Abstract

BACKGROUND: Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of the dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacted with the dengue serotype from 2012 to 2020 in Mexico.

METHOD: Information from 2469 notifying health units in Mexican municipalities was used for this cross-sectional analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status.

RESULTS: Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI 1.21, 1.74)], DENV-2 [1.33, (95% CI 1.18, 1.53)] and DENV-4 [3.78, (95% CI 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype.

CONCLUSION: The effect of pregnancy on severe dengue is moderated by the dengue serotype. Future studies on genetic diversification may potentially elucidate this serotype-specific effect among pregnant women in Mexico.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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