Maternal-fetal health in arboviral diseases: clinical outcomes following prenatal dengue and chikungunya virus infections

SUMMARYArthropod-borne viruses (arboviruses) are an increasingly important cause of global infectious disease, yet their effects during pregnancy and early life remain incompletely understood. In the context of declining fertility and birth rates globally, infectious threats to successful pregnancy and neonatal health warrant greater attention. Dengue virus (DENV) and chikungunya virus (CHIKV), two of the most prevalent mosquito-borne viruses, are underrecognized contributors to maternal-fetal health. Although these infections rarely result in classical congenital syndromes, accumulating clinical, epidemiological, and experimental evidence indicates that prenatal exposure can impair placental function, drive maternal immune dysregulation, and influence fetal and neonatal immune development. This review summarizes current knowledge on the maternal, placental, and pediatric consequences of DENV and CHIKV infection during pregnancy. We outline the immunological features of the maternal-fetal interface and discuss how pregnancy-associated immune modulation shapes antiviral responses and placental homeostasis. We then review epidemiological and clinical evidence linking prenatal arboviral infection with adverse pregnancy outcomes, neonatal disease, and potential long-term neurodevelopmental effects. Mechanistic insights, including viral immune evasion, placental inflammation, and antibody-mediated immunopathology, are examined. Finally, we discuss clinical considerations for monitoring arboviral-exposed pregnancies and progenies, alongside emerging strategies to reduce maternal infection and improve neonatal outcomes.