Clinical characteristics and obstetric outcomes of dengue fever in pregnancy: a nationwide population-based study in Taiwan

BACKGROUND: Dengue fever is a major mosquito-borne viral infection with rising global prevalence in tropical and subtropical regions. Pregnant women represent a particularly vulnerable population due to altered immune and physiological responses. While dengue is endemic in Southeast Asia, population-based data on maternal outcomes in East Asian populations with advanced healthcare systems like Taiwan are scarce. METHODS: A nationwide retrospective descriptive, non-comparative study identified 264 pregnant women with dengue (2012-2018) via the Taiwan NHIRD. Outcomes were analyzed descriptively; comparisons with national statistics are illustrative rather than formal risk estimates. RESULTS: The median maternal age was 32 years. The most common maternal intervention was Cesarean delivery (68.6%), while ICU admission occurred in 9.1%. For neonatal outcomes, a composite of preterm delivery or incubator care (aggregated due to coding limitations) occurred in 34.9%. Notably, the rate of low birth weight (9.5%) remained comparable to national baselines despite high intervention rates. CONCLUSIONS: High rates of obstetric intervention despite preserved biological outcomes may reflect defensive clinical practices and diagnostic uncertainty during epidemics. Refined guidelines are needed to balance safety and avoid unnecessary surgery.