Risk of adverse pregnancy and infant outcomes associated with prenatal Zika virus infection: a post-epidemic cohort in Central-West Brazil.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Zika Virus Infection*/complications ; Zika Virus Infection*/diagnosis ; Zika Virus Infection*/epidemiology ; Zika Virus* ; Microcephaly*/epidemiology ; Microcephaly*/etiology ; Pregnancy Complications, Infectious*/epidemiology ; Exanthema*/epidemiology ; Exanthema*/etiology; Infant, Newborn ; Child ; Humans ; Pregnancy ; Infant ; Female ; Prospective Studies ; Brazil/epidemiology ; Parturition

This study aimed to estimate the risks of adverse infant outcomes in the first year of life related to prenatal Zika virus (ZIKV) exposure. A prospective cohort of pregnant women with rash was recruited in Central-West Brazil in a post-epidemic period (January 2017 to April 2019). We evaluated participants' medical histories and performed ZIKV diagnostic testing using molecular (reverse transcription polymerase chain reaction [RT-PCR]) and serologic (immunoglobulin [Ig]M and plaque reduction neutralization tests [PRNT 90 ]) assays. The ZIKV-positive group included both RT-PCR-confirmed cases as well as IgM and/or PRNT 90 -positive probable cases. Children were evaluated at birth and in the first 12 months of life. Transfontanellar ultrasound, central nervous system computed tomography, eye fundoscopy and retinography were performed. We estimated the absolute risk and 95% confidence interval (95% CI) of adverse infant outcomes among confirmed prenatally ZIKV-exposed children. Among 81 pregnant women with rash, 43 (53.1%) were ZIKV infected. The absolute risk of microcephaly among offspring of ZIKV-infected pregnant women was 7.0% (95% CI: 1.5-19.1), including the two cases of microcephaly detected prenatally and one detected postnatally. In total, 54.5% (95% CI: 39.8-68.7) of children in the ZIKV-exposed group had at least one ophthalmic abnormality, with the most frequent abnormalities being focal pigmentary mottling and chorioretinal atrophy or scarring. Our findings reinforce the importance of long-term monitoring of prenatally ZIKV-exposed children born apparently asymptomatic for Congenital Zika Syndrome.
(© 2023. The Author(s).)

PLoS One. 2017 Apr 20;12(4):e0175065. (PMID: 28426680)
BMC Pregnancy Childbirth. 2022 Jan 10;22(1):25. (PMID: 35012473)
Am J Trop Med Hyg. 2022 Apr 11;:. (PMID: 35405646)
Viruses. 2020 Nov 28;12(12):. (PMID: 33260784)
BMC Infect Dis. 2021 Oct 27;21(1):1107. (PMID: 34706662)
N Engl J Med. 2016 May 19;374(20):1981-7. (PMID: 27074377)
PLoS Negl Trop Dis. 2021 Mar 8;15(3):e0009216. (PMID: 33684110)
Viruses. 2020 Nov 05;12(11):. (PMID: 33167566)
Prog Retin Eye Res. 2018 Sep;66:85-106. (PMID: 29698814)
PLoS Med. 2019 Mar 5;16(3):e1002755. (PMID: 30835728)
N Engl J Med. 2016 Mar 10;374(10):951-8. (PMID: 26862926)
Int J Environ Res Public Health. 2020 May 27;17(11):. (PMID: 32471131)
Viruses. 2021 Apr 23;13(5):. (PMID: 33922819)
Glob Health Action. 2019;12(1):1666566. (PMID: 31640505)
Radiology. 1991 Oct;181(1):129-33. (PMID: 1887021)
Sci Rep. 2020 Jul 29;10(1):12673. (PMID: 32728054)
Acta Paediatr Suppl. 2006 Apr;450:76-85. (PMID: 16817681)
J Pediatr. 2008 Dec;153(6):807-13. (PMID: 18657826)
PLoS One. 2021 Feb 19;16(2):e0246643. (PMID: 33606729)
MMWR Morb Mortal Wkly Rep. 2017 Mar 31;66(12):329-334. (PMID: 28358795)
Lancet. 2016 Feb 20;387(10020):719-21. (PMID: 26876373)
Emerg Infect Dis. 2008 Aug;14(8):1232-9. (PMID: 18680646)
J Dev Behav Pediatr. 2019 Jun;40(5):387-395. (PMID: 30921103)
N Engl J Med. 2018 Mar 15;378(11):985-994. (PMID: 29539287)
PLoS Med. 2017 Jan 3;14(1):e1002203. (PMID: 28045901)
PLoS One. 2020 Dec 15;15(12):e0242367. (PMID: 33320867)
Viral Immunol. 2008 Jun;21(2):123-32. (PMID: 18476771)
Trop Med Infect Dis. 2021 Oct 12;6(4):. (PMID: 34698287)
BJOG. 2021 Jan;128(2):317-326. (PMID: 32920998)
JAMA Netw Open. 2018 Dec 7;1(8):e186529. (PMID: 30646333)
N Engl J Med. 2016 Feb 18;374(7):601-4. (PMID: 26761185)
N Engl J Med. 2016 Dec 15;375(24):2321-2334. (PMID: 26943629)
JAMA Pediatr. 2017 Sep 1;171(9):847-854. (PMID: 28715527)
PLoS Negl Trop Dis. 2022 Jul 27;16(7):e0010602. (PMID: 35895718)
Lancet Infect Dis. 2018 Mar;18(3):328-336. (PMID: 29242091)
JAMA. 2017 Jan 3;317(1):59-68. (PMID: 27960197)
Lancet. 2014 Sep 6;384(9946):857-68. (PMID: 25209487)
Pediatrics. 2018 Feb;141(Suppl 2):S161-S166. (PMID: 29437049)
Prenat Diagn. 2019 May;39(6):420-430. (PMID: 30866073)
PLoS Negl Trop Dis. 2018 Mar 26;12(3):e0006362. (PMID: 29579059)
Viruses. 2021 Feb 22;13(2):. (PMID: 33671742)
BMJ. 2018 Oct 31;363:k4431. (PMID: 30381296)
Lancet. 2017 Aug 26;390(10097):861-870. (PMID: 28647172)
Heart. 2009 Sep;95(17):1385-92. (PMID: 19174420)
Glob Health Action. 2021 Oct 26;14(sup1):2008139. (PMID: 35377284)
Lancet Reg Health Am. 2023 Jan;17:. (PMID: 36714276)
Clin Microbiol Infect. 2019 Aug;25(8):1043-1044. (PMID: 30922930)
PLoS Negl Trop Dis. 2016 Sep 29;10(9):e0004953. (PMID: 27685649)
MMWR Morb Mortal Wkly Rep. 2018 Aug 10;67(31):858-867. (PMID: 30091967)
Lancet. 2017 Aug 26;390(10097):824-826. (PMID: 28647174)
BMJ Glob Health. 2020 May;5(5):. (PMID: 32381652)
BMJ Glob Health. 2021 Jun;6(6):. (PMID: 34117012)
MMWR Morb Mortal Wkly Rep. 2016 Mar 11;65(9):242-7. (PMID: 26963593)

224494/Z/21/Z United Kingdom WT_ Wellcome Trust

Date Created: 20230505 Date Completed: 20230508 Latest Revision: 20230511

20240513

PMC10161159

10.1038/s41598-023-33334-5

37147405