Journal article
Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy
JAMA : the journal of the American Medical Association, Vol.317(1), pp.59-68
01/03/2017
DOI: 10.1001/jama.2016.19006
PMID: 27960197
Abstract
Understanding the risk of birth defects associated with Zika virus infection during pregnancy may help guide communication, prevention, and planning efforts. In the absence of Zika virus, microcephaly occurs in approximately 7 per 10 000 live births.
To estimate the preliminary proportion of fetuses or infants with birth defects after maternal Zika virus infection by trimester of infection and maternal symptoms.
Completed pregnancies with maternal, fetal, or infant laboratory evidence of possible recent Zika virus infection and outcomes reported in the continental United States and Hawaii from January 15 to September 22, 2016, in the US Zika Pregnancy Registry, a collaboration between the CDC and state and local health departments.
Laboratory evidence of possible recent Zika virus infection in a maternal, placental, fetal, or infant sample.
Birth defects potentially Zika associated: brain abnormalities with or without microcephaly, neural tube defects and other early brain malformations, eye abnormalities, and other central nervous system consequences.
Among 442 completed pregnancies in women (median age, 28 years; range, 15-50 years) with laboratory evidence of possible recent Zika virus infection, birth defects potentially related to Zika virus were identified in 26 (6%; 95% CI, 4%-8%) fetuses or infants. There were 21 infants with birth defects among 395 live births and 5 fetuses with birth defects among 47 pregnancy losses. Birth defects were reported for 16 of 271 (6%; 95% CI, 4%-9%) pregnant asymptomatic women and 10 of 167 (6%; 95% CI, 3%-11%) symptomatic pregnant women. Of the 26 affected fetuses or infants, 4 had microcephaly and no reported neuroimaging, 14 had microcephaly and brain abnormalities, and 4 had brain abnormalities without microcephaly; reported brain abnormalities included intracranial calcifications, corpus callosum abnormalities, abnormal cortical formation, cerebral atrophy, ventriculomegaly, hydrocephaly, and cerebellar abnormalities. Infants with microcephaly (18/442) represent 4% of completed pregnancies. Birth defects were reported in 9 of 85 (11%; 95% CI, 6%-19%) completed pregnancies with maternal symptoms or exposure exclusively in the first trimester (or first trimester and periconceptional period), with no reports of birth defects among fetuses or infants with prenatal exposure to Zika virus infection only in the second or third trimesters.
Among pregnant women in the United States with completed pregnancies and laboratory evidence of possible recent Zika infection, 6% of fetuses or infants had evidence of Zika-associated birth defects, primarily brain abnormalities and microcephaly, whereas among women with first-trimester Zika infection, 11% of fetuses or infants had evidence of Zika-associated birth defects. These findings support the importance of screening pregnant women for Zika virus exposure.
Details
- Title: Subtitle
- Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy
- Creators
- Margaret A Honein - Centers for Disease Control and PreventionApril L Dawson - Centers for Disease Control and Prevention, Atlanta, GeorgiaEmily E Petersen - Centers for Disease Control and PreventionAbbey M Jones - Centers for Disease Control and PreventionEllen H Lee - New York City Department of Health and Mental HygieneMahsa M Yazdy - Massachusetts Department of Public HealthNina Ahmad - New York State Department of HealthJennifer Macdonald - Virginia Department of HealthNicole Evert - Texas Department of State Health ServicesAndrea Bingham - Florida Department of HealthSascha R Ellington - Centers for Disease Control and PreventionCarrie K Shapiro-Mendoza - Centers for Disease Control and PreventionTitilope Oduyebo - Centers for Disease Control and PreventionAnne D Fine - New York City Department of Health and Mental HygieneCatherine M Brown - Massachusetts Department of Public HealthJamie N Sommer - New York State Department of HealthJyoti Gupta - Virginia Department of HealthPhilip Cavicchia - Florida Department of HealthSally Slavinski - New York City Department of Health and Mental HygieneJennifer L White - New York State Department of HealthS Michele Owen - Centers for Disease Control and PreventionLyle R Petersen - Centers for Disease Control and PreventionColeen Boyle - Centers for Disease Control and PreventionDana Meaney-Delman - Centers for Disease Control and PreventionDenise J Jamieson - Centers for Disease Control and PreventionUS Zika Pregnancy Registry Collaboration
- Resource Type
- Journal article
- Publication Details
- JAMA : the journal of the American Medical Association, Vol.317(1), pp.59-68
- DOI
- 10.1001/jama.2016.19006
- PMID
- 27960197
- ISSN
- 0098-7484
- eISSN
- 1538-3598
- Language
- English
- Date published
- 01/03/2017
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446279102771
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