[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Pediatr Infect Dis J. 2019 Apr 10. doi: 10.1097/INF.0000000000002307. [Epub ahead of print]
Outcomes of Congenital Zika Virus Infection During an Outbreak in Valle del Cauca, Colombia.
Calle-Giraldo JP1, Rojas CA2, Hurtado IC2,3,4, Barco C2, Libreros D5,6, Sánchez PJ7, López P2,8, Arias A6, Dávalos DM9, Lesmes MC4, Pinzón E4, Ortiz VA4, López-Medina E2,6,8.
Author information: 1 From the Department of Pediatrics, Universidad del Quindío, Armenia, Colombia. 2 Department of Pediatrics, Universidad del Valle, Cali, Colombia. 3 Hospital Universitario del Valle, Cali, Colombia. 4 Department of Health, Valle del Cauca. Cali, Colombia. 5 Department of Ophthalmology, Universidad del Valle, Cali, Colombia. 6 Centro Médico Imbanaco. Cali, Colombia. 7 Department of Pediatrics, Nationwide Children´s Hospital, The Ohio State University College of Medicine, Columbus, Ohio. 8 Centro de Estudios en Infectología Pediátrica. Cali, Colombia. 9 Department of Public Health, Universidad Icesi, Cali, Colombia.
Despite increasing information in the literature regarding congenital Zika infection, gaps remain in our knowledge of its clinical manifestations.
We did a prospective observational study of exposed fetuses and infants whose mothers developed symptomatic and confirmed Zika infection during pregnancy in Valle del Cauca, Colombia. We performed neurological, ophthalmological and audiological evaluations, and classified outcomes as possibly or uncertainly related to Zika. Frequencies of outcomes were compared according to the trimester of pregnancy when infection occurred.
We evaluated 171 products of gestation including 17 pregnancy losses and 154 patients evaluated postnatally. Ninety (52.6%) pregnancies presented an adverse outcome, 36% possibly related with Zika and the remaining 64% of uncertain relation. Infection in the first trimester had the highest frequencies of adverse outcomes possibly related with Zika compared with the second and third trimesters (39% vs. 12.5% vs. 12%) with risk ratios of adverse outcomes possibly related to Zika in pregnancies infected in the first versus second or third trimester of 3.1 (95% CI: 2.4-4.1) and 3.3 (95% CI: 2.5-4.2), respectively. The frequencies of pregnancy loss and microcephaly were 9.4% and 4.5%, respectively. Auditory and ophthalmic abnormalities possibly related with Zika were present in 3% and 6% of the patients evaluated, respectively.
We observed a high frequency of gestational and neonatal complications in pregnant women who acquired Zika infection, especially in early pregnancy, resulting in a broad spectrum of clinical manifestations. Preventive measures are urgently needed to reduce the clinical burden during future Zika outbreaks.
PMID: 30985517 DOI: 10.1097/INF.0000000000002307
Keywords: Zika Virus; Pregancy; Zika Congenital Infection; Zika Congenital Syndrome; Microcephaly; Colombia.