Recent clinical observations emphasize the critical nature of perinatal dengue transmission, especially during large-scale outbreaks. This phenomenon occurs when the dengue virus (DENV) passes from a pregnant woman to her fetus or newborn. Consequently, this transmission can lead to various complications, ranging from mild fever to severe neonatal distress. A recent study in Argentina detailed six cases of vertical transmission involving DENV-2, offering valuable insights for clinicians worldwide.

Clinical Presentation in Pregnant Mothers

During the study, most pregnant women developed symptoms shortly before or after giving birth. Specifically, fever and headache affected 66.7% of the mothers. Thrombocytopenia was also a common finding, matching the frequency of other symptoms. Notably, some women experienced more severe complications, such as gynecorrhagia and pleural effusion. The median interval from the onset of maternal symptoms to delivery was four days. Therefore, healthcare providers must monitor symptomatic pregnant women closely during the peripartum period.

Neonatal Outcomes and Symptoms

All newborns in this series were full-term and had appropriate birth weights. However, five out of six neonates became symptomatic. Fever was the most frequent manifestation, occurring in 83.3% of the infants. Additionally, many neonates experienced respiratory distress. Laboratory tests revealed thrombocytopenia in half of the cases. One severe case even involved plasma leakage, a hallmark of severe dengue. Despite these challenges, all newborns recovered well after receiving supportive care for approximately nine days.

Managing Perinatal Dengue Transmission

Effective management of perinatal dengue transmission requires early diagnostic suspicion. Clinicians should include dengue in the differential diagnosis for any neonate presenting with fever or sepsis-like symptoms in endemic regions. Early testing for NS1 antigen and IgM antibodies is essential for both the mother and the infant. Furthermore, supportive care remains the primary treatment strategy. This includes careful fluid management and monitoring of platelet counts to prevent further complications.

Conclusion

Vertical transmission of DENV-2 can cause significant neonatal illness even in full-term infants. Therefore, medical professionals must stay vigilant during outbreaks. Early recognition and adequate clinical management are vital for ensuring favorable outcomes for both mothers and their babies.

Frequently Asked Questions

What are the common symptoms of neonatal dengue?

Common symptoms include fever, respiratory distress, and thrombocytopenia. In some severe cases, neonates may also experience plasma leakage or bleeding tendencies.

When does vertical transmission of dengue typically occur?

Transmission usually occurs when the mother develops symptoms near the time of delivery. In this series, the median time from maternal symptom onset to birth was four days.

How is perinatal dengue managed?

Management is primarily supportive. Doctors focus on symptomatic relief, fluid balance, and close monitoring of laboratory parameters like platelet counts.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or establish a doctor-patient relationship. Always seek the advice of a qualified healthcare provider for any medical concerns. Refer to the latest local and national guidelines for clinical practice.

References

Quipildor MO et al. Perinatal Transmission of Dengue Virus Type 2 in Northern Argentina: A Series of 6 Cases. Pediatr Infect Dis J. 2026 Mar 10. doi: 10.1097/INF.0000000000005212. PMID: 41805264.

National Center for Vector Borne Diseases Control (NCVBDC). National Guidelines for Clinical Management of Dengue Fever. Ministry of Health & Family Welfare, Government of India; 2023.

World Health Organization. National Guideline for Clinical Management of Dengue. WHO; 2022.