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Clin Microbiol Infect. 2018 Jun;24(6):646-652. doi: 10.1016/j.cmi.2017.11.004. Epub 2017 Nov 10.

Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil.

Author information

1
São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil. Electronic address: mnogueira@famerp.br.
2
Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
3
São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil.
4
São Paulo State University, São José do Rio Preto, São Paulo, Brazil.
5
Evandro Chagas Institute, Ananindeua, Pará, Brazil.
6
Health Secretariat, São José do Rio Preto, São Paulo, Brazil.
7
Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Federal University of Bahia, Salvador, Bahia, Brazil; Yale School of Public Health, New Haven, CT, USA.
8
Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil.
9
University of Texas Medical Branch (UTMB), Galveston, TX, USA.
10
Yale School of Public Health, New Haven, CT, USA.

Abstract

OBJECTIVES:

We aimed to report the first 54 cases of pregnant women infected by Zika virus (ZIKV) and their virologic and clinical outcomes, as well as their newborns' outcomes, in 2016, after the emergence of ZIKV in dengue-endemic areas of São Paulo, Brazil.

METHODS:

This descriptive study was performed from February to October 2016 on 54 quantitative real-time PCR ZIKV-positive pregnant women identified by the public health authority of São José do Rio Preto, São Paulo, Brazil. The women were followed and had clinical and epidemiologic data collected before and after birth. Adverse outcomes in newborns were analysed and reported. Urine or blood samples from newborns were collected to identify ZIKV infection by reverse transcription PCR (RT-PCR).

RESULTS:

A total of 216 acute Zika-suspected pregnant women were identified, and 54 had the diagnosis confirmed by RT-PCR. None of the 54 women miscarried. Among the 54 newborns, 15 exhibited adverse outcomes at birth. The highest number of ZIKV infections occurred during the second and third trimesters. No cases of microcephaly were reported, though a broad clinical spectrum of outcomes, including lenticulostriate vasculopathy, subependymal cysts, and auditory and ophthalmologic disorders, were identified. ZIKV RNA was detected in 18 of 51 newborns tested and in eight of 15 newborns with adverse outcomes.

CONCLUSIONS:

Although other studies have associated many newborn outcomes to ZIKV infection during pregnancy, these same adverse outcomes were rare or nonexistent in this study. The clinical presentation the newborns we studied was mild compared to other reports, suggesting that there is significant heterogeneity in congenital Zika infection.

KEYWORDS:

Adverse outcome; Arbovirus; Birth; Pregnancy; Zika virus

PMID:
29133154
DOI:
10.1016/j.cmi.2017.11.004
[Indexed for MEDLINE]
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