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MMWR Morb Mortal Wkly Rep. 2017 Apr 7;66(13):366-373. doi: 10.15585/mmwr.mm6613e1.

Vital Signs: Update on Zika Virus-Associated Birth Defects and Evaluation of All U.S. Infants with Congenital Zika Virus Exposure - U.S. Zika Pregnancy Registry, 2016.

Collaborators (215)

Adair J1, Ruberto I2, Haselow DT3, Im L3, Jilek W4, Lehmann MS5, Olney R4, Porse CC4, Ramstrom KC4, Sowunmi S4, Marzec NS6, Davis K7, Esponda-Morrison B7, Fraser MZ7, O'Connor CA7, Chung W8, Richardson F8, Sexton T8, Stocks ME8, Woldai S8, Bundek AM9, Zambri J10, Goldberg C11, Eisenstein L12, Jackson J13, Kopit R14, Logue T15, Mendoza R16, Feldpausch A17, Graham T17, Mann S18, Park SY18, Carter KK19, Potts EJ20, Stevens T20, Simonson S21, Tonzel JL21, Davis S22, Robinson S23, Hyun JK24, Jenkins EM24, Piccardi M24, Reid LD24, Dunn JE25, Higgins CA25, Lin AE26, Munshi GS25, Sandhu K25, Scotland SJ25, Soliva S25, Copeland G27, Signs KA27, Schiffman E28, Byers P29, Hand S29, Mulgrew CL30, Hamik J31, Koirala S31, Ludwig LA31, Fredette CR32, Garafalo K33, Worthington K33, Ropri A34, Ade JN35, Alaali ZS35, Blog D35, Brunt SJ36, Bryant P36, Burns AE35, Bush S36, Carson K35, Dean AB36, Demarest V36, Dufort EM35, Dupuis Ii AP36, Sullivan-Frohm A35, Furuya AM36, Fuschino M36, Glaze VH37, Griffin J35, Hidalgo C35, Kulas KE36, Lamson DM36, Lance LA35, Lee WT36, Limberger R36, Many PS35, Marchewka MJ36, Naizby BE35, Polfleit M35, Popowich M36, Rahman T35, Rem T35, Robbins AE35, Rowlands JV35, Seaver C35, Seward KA35, Smith L35, Sohi I35, St George K36, Souto MI38, Wester RE35, Wong SJ36, Zeng L36, Ackelsberg J39, Alex B39, Ballen V39, Baumgartner J39, Bloch D39, Clark S39, Conners E39, Cooper H39, Davidson A39, Dentinger C39, Deocharan B39, DeVito A39, Fu J39, Hrusa G39, Iqbal M39, Iwamoto M39, Jones L39, Kubinson H39, Lash M39, Layton M39, Lee CT39, Liu D39, McGibbon E39, Moy M39, Ngai S39, Parton HB39, Peterson E39, Poy J39, Rakeman J39, Stoute A39, Thompson C39, Weiss D39, Westheimer E39, Winters A39, Younis M39, Chan RL40, Cronquist LJ41, Caton L42, Lind L43, Nalluswami K43, Perella D44, Brady DS45, Gosciminski M45, McAuley P45, Drociuk D46, Leedom V47, Witrick B46, Bollock J48, Hartel MB49, Lucinski LS49, McDonald M49, Miller AM49, Ponson TA49, Price L49, Nance AE50, Peterson D51, Cook S52, Martin B52, Oltean H53, Neary J53, Baker MA54, Cummons K54, Bryan K55, Arnold KE56, Arth AC56, Bollweg BC56, Cragan JD56, Dawson AL56, Denison AM56, Dziuban EJ56, Estetter L56, Silva-Flannery L56, Free RJ56, Galang RR56, Gary J56, Goldsmith CS56, Green C56, Hale GL56, Hayes HM56, Igbinosa I56, Keating MK56, Khan S57, Kim SY56, Lampe M56, Lewis A56, Mai C56, Martines RB56, Miers B56, Moore J56, Muehlenbachs A56, Nahabedian J56, Panella A56, Parihar V56, Patel MM56, Rabeneck DB56, Rasmussen SA56, Ritter JM56, Rollin DC56, Sanders JH56, Shieh WJ56, Simeone RM56, Simon EL56, Sims JR56, Spivey PJ56, Talley-McRae H56, Tshiwala AK56, VanMaldeghem K56, Viens L56, Wainscott-Sargent A58, Williams T56, Zaki S56.

Author information

1
Maricopa County Department of Public Health, Arizona.
2
Arizona Department of Health Services.
3
Arkansas Department of Health.
4
California Department of Public Health.
5
California Department of Public Health, Center for Family Health, California Birth Defects Monitoring Program.
6
Colorado Department of Public Health and Environment.
7
Connecticut Department of Public Health.
8
Dallas County Health and Human Services.
9
Delaware Division of Public Health.
10
Delaware Division of Public Health, Office of Infectious Disease Epidemiology.
11
Miami, Dade County Health Department, Florida Department of Health.
12
Florida Department of Health.
13
Orange County Health Department, Florida Department of Health.
14
Palm Beach County Health Department, Florida Department of Health.
15
Miami/Dade County Health Department, Florida Department of Health.
16
Broward County Health Department, Florida Department of Health.
17
Georgia Department of Public Health.
18
Hawaii Department of Health.
19
Idaho Division of Public Health, CDC, U.S. Public Health Service.
20
Indiana State Department of Health.
21
Louisiana Department of Health.
22
Maine Center for Disease Control and Prevention.
23
Maine Department of Health and Human Services.
24
Maryland Department of Health and Mental Hygiene.
25
Massachusetts Department of Public Health.
26
Massachusetts General Hospital for Children.
27
Michigan Department of Health and Human Services.
28
Minnesota Department of Health.
29
Mississippi State Department of Health.
30
State of Montana.
31
Division of Public Health, Nebraska Department of Health and Human Services.
32
New Hampshire Department of Health and Human Services.
33
New Jersey Department of Health.
34
New Mexico State Department of Health.
35
New York State Department of Health.
36
Wadsworth Center, New York State Department of Health.
37
Health Research Inc.
38
Rockland County Department of Health.
39
New York City Department of Health & Mental Hygiene.
40
North Carolina Department of Health and Human Services, Division of Public Health.
41
North Dakota Department of Health, Division of Disease Control.
42
Oklahoma State Department of Health.
43
Pennsylvania Department of Health.
44
Philadelphia Department of Public Health.
45
Rhode Island Department of Health.
46
South Carolina Department of Health & Environmental Control, Division of Acute Disease Epidemiology.
47
South Carolina Department of Health & Environmental Control, Division of Maternal and Child Health.
48
South Dakota Department of Health DIS.
49
Tennessee Department of Health.
50
Utah Birth Defect Network, Utah Department of Health.
51
Utah Department of Health.
52
Vermont Department of Health.
53
Washington State Department of Health.
54
West Virginia Office of Maternal, Child and Family Health.
55
Wyoming Department of Health.
56
CDC.
57
CDC,, ORISE.
58
Carter Consulting.

Abstract

BACKGROUND:

In collaboration with state, tribal, local, and territorial health departments, CDC established the U.S. Zika Pregnancy Registry (USZPR) in early 2016 to monitor pregnant women with laboratory evidence of possible recent Zika virus infection and their infants.

METHODS:

This report includes an analysis of completed pregnancies (which include live births and pregnancy losses, regardless of gestational age) in the 50 U.S. states and the District of Columbia (DC) with laboratory evidence of possible recent Zika virus infection reported to the USZPR from January 15 to December 27, 2016. Birth defects potentially associated with Zika virus infection during pregnancy include brain abnormalities and/or microcephaly, eye abnormalities, other consequences of central nervous system dysfunction, and neural tube defects and other early brain malformations.

RESULTS:

During the analysis period, 1,297 pregnant women in 44 states were reported to the USZPR. Zika virus-associated birth defects were reported for 51 (5%) of the 972 fetuses/infants from completed pregnancies with laboratory evidence of possible recent Zika virus infection (95% confidence interval [CI] = 4%-7%); the proportion was higher when restricted to pregnancies with laboratory-confirmed Zika virus infection (24/250 completed pregnancies [10%, 95% CI = 7%-14%]). Birth defects were reported in 15% (95% CI = 8%-26%) of fetuses/infants of completed pregnancies with confirmed Zika virus infection in the first trimester. Among 895 liveborn infants from pregnancies with possible recent Zika virus infection, postnatal neuroimaging was reported for 221 (25%), and Zika virus testing of at least one infant specimen was reported for 585 (65%).

CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE:

These findings highlight why pregnant women should avoid Zika virus exposure. Because the full clinical spectrum of congenital Zika virus infection is not yet known, all infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy should receive postnatal neuroimaging and Zika virus testing in addition to a comprehensive newborn physical exam and hearing screen. Identification and follow-up care of infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy and infants with possible congenital Zika virus infection can ensure that appropriate clinical services are available.

PMID:
28384133
PMCID:
PMC5657905
DOI:
10.15585/mmwr.mm6613e1
[Indexed for MEDLINE]
Free PMC Article

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