# Maternal–Fetal Implications of Chikungunya Virus Infection: An Updated Review

## TL;DR

This paper reviews the risks of Chikungunya virus during pregnancy, focusing on how it affects mothers and newborns, and highlights the need for better management and prevention strategies.

## Contribution

The paper provides an updated synthesis of maternal-fetal implications of CHIKV infection, emphasizing gaps in long-term outcomes and management strategies.

## Key findings

- Vertical transmission during peripartum period can cause severe neonatal outcomes like encephalopathy and neurodevelopmental impairment.
- Diagnosis relies on RT-PCR in the acute phase and IgM serology later, with supportive treatment as no antivirals are approved for pregnancy.
- Prevention focuses on vector control and surveillance, with delivery planning and neonatal monitoring crucial for late-term infections.

## Abstract

Chikungunya virus (CHIKV) infection during pregnancy represents an increasing public health concern, especially in endemic and epidemic regions. The main concern is vertical transmission, particularly during the peripartum period, which can lead to severe neonatal outcomes such as encephalopathy, hematologic abnormalities, and long-term neurodevelopmental impairment. This review synthesizes current knowledge on pathophysiology, clinical manifestations, diagnosis, maternal and neonatal outcomes, and management of CHIKV infection in pregnancy. Diagnosis relies on clinical evaluation supported by laboratory confirmation, RT-PCR in the acute phase and IgM serology thereafter. Treatment is supportive, using acetaminophen as first-line therapy and corticosteroids for selected refractory cases. No antivirals or vaccines are approved for use in pregnancy as of 2025. Prevention is centered on vector control, personal protection, and epidemiological surveillance. Delivery planning and neonatal monitoring are essential when infection occurs close to term due to the high risk of peripartum transmission. Despite growing recognition of CHIKV’s maternal–fetal impact, significant gaps remain regarding long-term outcomes and optimal management strategies. Strengthening prenatal care, neonatal preparedness, and surveillance systems is crucial to mitigate adverse outcomes and inform future clinical and public health policies.