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8 Jun 2017

#Pregnancy #Outcomes After Maternal #Zika Virus #Infection During Pregnancy — #US #Territories, Jan 1 ‘16–Apr 25 ‘17 (@CDCgov, MMWR)


Title: #Pregnancy #Outcomes After Maternal #Zika Virus #Infection During Pregnancy — #US #Territories, Jan 1 ‘16–Apr 25 ‘17.

Subject: Zika Virus Infection during pregnancy, surveillance for outcome in US Territories.

Source: US Centers for Disease Control and Prevention (CDC), MMWR Morbidity and Mortality Weekly Report, full page: (LINK). Abstract, edited.

Code: [     ]

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Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy — U.S. Territories, January 1, 2016–April 25, 2017

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Early Release / June 8, 2017 / 66

Format: [ File [144K] ]

Carrie K. Shapiro-Mendoza, PhD1; Marion E. Rice, MPH2,3; Romeo R. Galang, MD2; Anna C. Fulton, MPH2; Kelley VanMaldeghem, MPH2; Miguel Valencia Prado, MD4; Esther Ellis, PhD5; Magele Scott Anesi, MPH6; Regina M. Simeone, MPH2; Emily E. Petersen, MD1; Sascha R. Ellington, MSPH1; Abbey M. Jones, MPH2; Tonya Williams, PhD7; Sarah Reagan-Steiner, MD8; Janice Perez-Padilla, MPH9; Carmen C. Deseda, MD4; Andrew Beron, MPH, MLS5; Aifili John Tufa, MPH10; Asher Rosinger, PhD11,12; Nicole M. Roth, MPH2; Caitlin Green, MPH2; Stacey Martin, MSc9; Camille Delgado Lopez, MPH4; Leah deWilde5; Mary Goodwin, MA, MPA1; H. Pamela Pagano, DrPH1; Cara T. Mai, DrPH2; Carolyn Gould, MD9; Sherif Zaki, MD8; Leishla Nieves Ferrer, MPH4; Michelle S. Davis, PhD5; Eva Lathrop, MD2; Kara Polen, MPH2; Janet D. Cragan, MD2; Megan Reynolds, MPH2; Kimberly B. Newsome, MPH2; Mariam Marcano Huertas4; Julu Bhatangar, PhD8; Alma Martinez Quiñones, MPH4; John F. Nahabedian, MS2; Laura Adams, DVM9; Tyler M. Sharp, PhD9; W. Thane Hancock, MD13; Sonja A. Rasmussen, MD15; Cynthia A. Moore, MD, PhD2; Denise J. Jamieson, MD1; Jorge L. Munoz-Jordan, PhD9; Helentina Garstang, DCHMS16; Afeke Kambui, MPH10; Carolee Masao, DCHMS17; Margaret A. Honein, PhD2; Dana Meaney-Delman, MD14; Zika Pregnancy and Infant Registries Working Group

Authors Affiliations: 1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC; 2Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC; 3Oak Ridge Institute for Science and Education; 4Puerto Rico Department of Health; 5U.S. Virgin Islands Department of Health; 6American Samoa Department of Health; 7Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC; 8Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 9Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 10Pacific Island Health Officers Association; 11Epidemic Intelligence Service, CDC; 12Division of Health Nutrition Examination Surveys, National Center for Health Statistics, CDC; 13Division of State and Local Readiness, Office of Public Health Preparedness and Response, CDC; 14Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 15Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services; 16Republic of the Marshall Islands Ministry of Health; 17Kosrae Department of Health Services, Federated States of Micronesia.

Corresponding author: Margaret A. Honein, mrh7@cdc.gov, 770-402-0160.

Suggested citation for this article: Shapiro-Mendoza CK, Rice ME, Galang RR, et al. Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy — U.S. Territories, January 1, 2016–April 25, 2017. MMWR Morb Mortal Wkly Rep . ePub: 8 June 2017. DOI: http://dx.doi.org/10.15585/mmwr.mm6623e1.


Summary

  • What is already known about this topic?
    • Zika virus infection during pregnancy causes serious brain abnormalities and/or microcephaly and has been associated with other severe birth defects.
    • Local transmission of Zika virus was reported in U.S. territories in 2016.
  • What is added by this report?
    • Overall, about 5% of fetuses and infants born to women with laboratory evidence of recent possible Zika virus infection in the U.S. territories had possible Zika-associated birth defects, the same as the percentage reported in the 50 U.S. states during 2016.
    • Possible Zika-associated birth defects including brain abnormalities and/or microcephaly were reported following Zika virus infection during every trimester of pregnancy.
    • Among completed pregnancies with positive nucleic acid tests confirming Zika virus infection identified in the first, second, and third trimesters, the percentages of fetuses or infants with possible Zika-associated birth defects was 8%, 5%, and 4%, respectively.
  • What are the implications for public health practice?
    • Current data suggest that Zika virus infection during any trimester of pregnancy might result in Zika-associated birth defects.
    • Identification and follow-up of infants born to women with laboratory evidence of recent possible Zika virus infection during pregnancy can facilitate timely and appropriate clinical intervention services and assessment of future needs.
    • Information about adherence to the recommended newborn testing and screening can improve monitoring and care of infants affected by Zika.


Abstract

Pregnant women living in or traveling to areas with local mosquito-borne Zika virus transmission are at risk for Zika virus infection, which can lead to severe fetal and infant brain abnormalities and microcephaly (1). In February 2016, CDC recommended 1) routine testing for Zika virus infection of asymptomatic pregnant women living in areas with ongoing local Zika virus transmission at the first prenatal care visit, 2) retesting during the second trimester for women who initially test negative, and 3) testing of pregnant women with signs or symptoms consistent with Zika virus disease (e.g., fever, rash, arthralgia, or conjunctivitis) at any time during pregnancy (2). To collect information about pregnant women with laboratory evidence of recent possible Zika virus infection* and outcomes in their fetuses and infants, CDC established pregnancy and infant registries (3). During January 1, 2016–April 25, 2017, U.S. territories with local transmission of Zika virus reported 2,549 completed pregnancies§ (live births and pregnancy losses at any gestational age) with laboratory evidence of recent possible Zika virus infection; 5% of fetuses or infants resulting from these pregnancies had birth defects potentially associated with Zika virus infection (4,5). Among completed pregnancies with positive nucleic acid tests confirming Zika infection identified in the first, second, and third trimesters, the percentage of fetuses or infants with possible Zika-associated birth defects was 8%, 5%, and 4%, respectively. Among liveborn infants, 59% had Zika laboratory testing results reported to the pregnancy and infant registries. Identification and follow-up of infants born to women with laboratory evidence of recent possible Zika virus infection during pregnancy permits timely and appropriate clinical intervention services (6).


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Keywords: Zika Virus; Zika Congenital Infection; Microcephaly; Pregnancy; US CDC; USA; Updates.

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