Early maternal Zika infection predicts severe neonatal neurological damage: results from the prospective Natural History of Zika Virus Infection in Gestation cohort study
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Le résumé fourni par la source
OBJECTIVE: To define the prevalence of adverse outcomes of maternal infection in a large cohort of ZIKV-infected Brazilian women and their infants. DESIGN: Prospective population-based cohort study. SETTING: Ribeirão Preto's region's private and public health facilities. POPULATION: Symptomatic ZIKV-infected mothers and their infants. METHODS: Prenatal/early neonatal data were obtained for all mother-child pairs. A subgroup of infants had cranial ultrasonography, eye fundoscopy, hearing and neurological examinations and Bayley III screening tests within 3 months of age. MAIN OUTCOME MEASURES: Prevalence of pregnancy losses and anomalies detected at birth or within 3 months according to the gestational age of infection. RESULTS: Overall, 511 ZIKV-infected women were identified from a total of 1116 symptomatic women; as there were two twins, there were a total of 513 fetuses included. Of these, 13 (2.5%; 95% CI 1.5-4.3) presented with major signs of congenital Zika syndrome (CZS). Of the 511 women, there were 489 livebirths and 24 (4.7%) pregnancy losses (20 miscarriages and four stillbirths). ZIKV-related anomalies occurred in the offspring of 42/511 (8.2%) mothers. Microcephaly or other CNS malformations were diagnosed in 1/4 (25.0%) stillbirths and in 19/489 (3.9%; 95% CI 2.5-5.9) of the liveborn infants. Fetal abnormalities were 14.0 (95% CI 7.6-26.0) times more likely with gestational infection occurring in ≤11 weeks. On follow up of 280 asymptomatic infants, 2/155 (1.3%) had eye abnormalities, 1/207 (0.5%) had CNS imaging findings and 16/199 (8%) presented neurological alert signs. CONCLUSIONS: This prospective population-based study represents the largest Brazilian cohort study of ZIKV in pregnancy. Congenital anomalies potentially associated with CZS are less frequent than previously thought. There is a strong association between the gestational age of infection (≤11 weeks) and a poorer early infant prognosis. A notable proportion of apparently asymptomatic newborns can present with subclinical findings within 3 months of age. TWEETABLE ABSTRACT: ZIKV and pregnancy: adverse outcomes are less common, more prevalent for first-trimester infections, and potentially subclinical.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Early maternal Zika infection predicts severe neonatal neurological damage: results from the prospective Natural History of Zika Virus Infection in Gestation cohort study
- Date Crossref
- 08/10/2020
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Universidade de São Paulo pays non établi dans la noticeUniversité ou école supérieure
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Clinics Hospital of Ribeirão Preto pays non établi dans la noticeÉtablissement de santé
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Apple (Israel) pays non établi dans la noticeEntreprise
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Department of Gynaecology and Obstetrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil pays non établi dans la noticeUniversité ou école supérieure
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Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil pays non établi dans la noticeUniversité ou école supérieure
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Epidemiology and Disease Control Division Department of Public Health and Surveillance Secretary of Health Ribeirão Preto Brazil pays non établi dans la noticeInstitution
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Haematology and Oncology Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil Department of Imaging pays non établi dans la noticeUniversité ou école supérieure
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Rehabilitation Centre of Clinics Hospital at the Ribeirão Preto School of Medicine Ribeirão Preto Brazil pays non établi dans la noticeUniversité ou école supérieure
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Department of Health Sciences Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil pays non établi dans la noticeUniversité ou école supérieure
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Division of Ophthalmology Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil pays non établi dans la noticeUniversité ou école supérieure
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The list of NATZIG cohort study members can be found in Appendix 1 pays non établi dans la noticeInstitution
Universidade de São Paulo, Clinics Hospital of Ribeirão Preto et Apple (Israel), avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.