Fatores associados a dengue com sinais de alarme, dengue grave e hospitalização em gestantes, no estado do Espírito Santo, 2015 a 2019
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Data
2024-09-04
Autores
Santana, Lutigardes Bastos
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Universidade Federal do Espírito Santo
Resumo
Introduction: Dengue is a viral disease transmitted by the Aedes aegypti mosquito, prevalent in tropical and subtropical areas. Some groups are more susceptible to developing severe forms of the disease, including pregnant women, postpartum women, and children under one year of age. During pregnancy, early diagnosis of dengue can be difficult not only due to its varied clinical spectrum and similarity to other infectious diseases, but also due to the possibility of confusion with physiological changes during pregnancy. Objective: To identify whether there is an association between dengue with warning signs, severe dengue, and hospitalization of pregnant women notified with dengue, aged 15 to 49, in Espírito Santo, from 2015 to 2019. Methods: Cross-sectional study of cases of pregnant women aged 15 to 49, notified with dengue, by clinical, epidemiological, and laboratory criteria, in the state of Espírito Santo, using data from the Notifiable Diseases Information System (SINAN). The outcomes of dengue with warning signs, severe dengue, hospitalization and death were evaluated. Since the outcome variables were not frequent, they were grouped for analysis purposes in a single group. The independent variables of the study were age, gestational period, race/color, education, time of seeking care, final classification and clinical evolution, clinical signs for dengue with warning signs and severe dengue, and symptoms and pre-existing diseases. Results: Among the 1,020 pregnant women who participated in the study, 88.6% were reported with dengue, 10.7% with dengue with warning signs and 0.7% with severe dengue. Most of the pregnant women reported were between 20 and 34 years old (68.4%), 49.4% were black or brown and 35.6% had between 8 and 11 years of education. Considering the evolution of the case, there were no deaths among the group analyzed, and as for hospitalization, it was recorded that 9.8% were hospitalized, while 59.4% were not hospitalized and 30.8% had the information ignored. The highest proportion of hospitalizations occurred in the third trimester of pregnancy (4.7%), followed by the second (3%) and first (1.9%) trimesters. Pregnant women in the third trimester were twice as likely to develop severe forms of dengue compared to the first trimester (OR 2; CI 1.2-3.33; p = 0.08), and there was a greater chance of hospitalization in cases where there was a late search for care (OR 2.24; CI 1.41-3.56; p = 0.01). Conclusions: Pregnant women in the third trimester and those who sought care late had a higher risk of serious complications and hospitalization due to dengue. These findings highlight the need for early intervention and strict monitoring to reduce the risks associated with dengue during pregnancy
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Dengue , Grávidas , Epidemiologia , Sistema de Informação de Agravos de Notificação (SINAN) , Pregnant women , Epidemiology