Gottesfeld–Hohler Memorial Foundation Zika Virus Think Tank Summary

Abstract

At a think tank bringing together experts on fetal neuroimaging, obstetric infectious diseases, and public health, we discussed trends in all of these areas for Zika virus. There is a wide variety of imaging findings in affected fetuses, influenced by timing of infection and probably host factors. The resources for diagnosis and interventions also vary by location with the hardest hit areas often having the fewest resources. We identified potential areas for both research and clinical collaboration as the Zika virus epidemic continues to evolve.

Association of Prenatal Ultrasonographic Findings With Adverse Neonatal Outcomes Among Pregnant Women With Zika Virus Infection in Brazil

“…One potential limitation is that this cohort is derived from patients at a single study site in Brazil, which may limit the generalizability of our findings to other regions that have reported varying rates of birth defects from Zika virus infection. 1 Because this was an observational cohort, many women enrolled in the parent study declined prenatal ultrasonographic examination, citing the burden of traveling to the obstetrical facility (although all were offered transportation from their homes) or fear of possible fetal abnormalities related to Zika virus infection. 2 This could contribute to selection bias in our cohort, although patient autonomy in decision making surrounding prenatal screening tests is a real-world consideration.…”

“…The rate of abnormal perinatal outcomes after maternal Zika virus infection has been estimated to be from 6% to 55% for infections acquired in the first trimester and from 3% to 29% for infections acquired in the third trimester. 1 The spectrum of anomalies associated with maternal Zika virus infection is still being characterized, and most information to date has been gleaned from retrospective cohorts and case-control studies. [2][3][4][5][6][7][8][9][10] Recent reports evaluating the predictive value of prenatal ultrasonography are limited because they included cohorts identified prenatally or postnatally with microcephaly alone and did not include all pregnant women infected with Zika virus.…”

“…As such, the challenge for clinicians is to identify which maternal Zika virus infections will have an abnormal neonatal outcome. 1,22 Prenatal screening of potentially infected fetuses is critical for patient counseling of pregnancy care options, as well as optimizing the delivery setting and care of the neonate. However, the association of prenatal ultrasonographic findings with neonatal outcomes from Zika virus infection remains to be fully defined.…”

“…The rate of abnormal perinatal outcomes after maternal Zika virus infection has been estimated to be from 6% to 55% for infections acquired in the first trimester and from 3% to 29% for infections acquired in the third trimester . The spectrum of anomalies associated with maternal Zika virus infection is still being characterized, and most information to date has been gleaned from retrospective cohorts and case-control studies .…”