Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection — 15 States and U.S. Territories, 2016

Delaney, Augustina; Mai, Cara; Smoots, Ashley N.; Cragan, Janet D.; Ellington, Sascha; Langlois, Peter H.; Breidenbach, Rebecca; Fornoff, Jane; Dunn, Julie E.; Yazdy, Mahsa M.; Scotto-Rosato, Nancy; Sweatlock, Joseph; Fox, Deborah; Palacios, Jessica; Forestieri, Nina; Leedom, Vinita; Smiley, M R; Nance, Amy; Lake-Burger, Heather; Romitti, Paul A.; Fall, Carrie; Prado, Miguel Valencia; Barton, Jerusha; Bryan, Jacqueline; Arias, William; Brown, Samara Viner; Kimura, Jonathan; Mann, Sylvia; Martin, Brennan; Orantes, Lucia C.; Taylor, Amber W.; Nahabedian, John F.; Akosa, Amanda; Song, Ziwei; Martin, Stacey W.; T., Ramlal, Roshan; Shapiro-Mendoza, Carrie K.; Isenburg, Jennifer; Moore, Cynthia A.; Gilboa, Suzanne M.; Honein, Margaret A.

doi:10.15585/mmwr.mm6703a2

Cited by 50 publications

(52 citation statements)

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“…Data for each child were reviewed by at least two reviewers; discrepant review findings were discussed among clinical subject matter experts to reach agreement. Although the category of neural tube defects and other early brain malformations was initially included in the surveillance case definition for Zika-associated birth defects, it was excluded in this report because of growing evidence suggesting a lack of association of these defects with congenital Zika virus infection ( 6 , 20 ). Postnatal-onset microcephaly detected during follow-up care is distinct from microcephaly detected at birth and is included among neurodevelopmental abnormalities possibly associated with congenital Zika virus infection (Box).…”

Section: Methodsmentioning

confidence: 99%

Vital Signs:Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection — U.S. Territories and Freely Associated States, 2018

Rice¹,

Galang²,

Roth³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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IntroductionZika virus infection during pregnancy causes serious birth defects and might be associated with neurodevelopmental abnormalities in children. Early identification of and intervention for neurodevelopmental problems can improve cognitive, social, and behavioral functioning.MethodsPregnancies with laboratory evidence of confirmed or possible Zika virus infection and infants resulting from these pregnancies are included in the U.S. Zika Pregnancy and Infant Registry (USZPIR) and followed through active surveillance methods. This report includes data on children aged ≥1 year born in U.S. territories and freely associated states. Receipt of reported follow-up care was assessed, and data were reviewed to identify Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection.ResultsAmong 1,450 children of mothers with laboratory evidence of confirmed or possible Zika virus infection during pregnancy and with reported follow-up care, 76% had developmental screening or evaluation, 60% had postnatal neuroimaging, 48% had automated auditory brainstem response-based hearing screen or evaluation, and 36% had an ophthalmologic evaluation. Among evaluated children, 6% had at least one Zika-associated birth defect identified, 9% had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection identified, and 1% had both.ConclusionOne in seven evaluated children had a Zika-associated birth defect, a neurodevelopmental abnormality possibly associated with congenital Zika virus infection, or both reported to the USZPIR. Given that most children did not have evidence of all recommended evaluations, additional anomalies might not have been identified. Careful monitoring and evaluation of children born to mothers with evidence of Zika virus infection during pregnancy is essential for ensuring early detection of possible disabilities and early referral to intervention services.

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Section: Methodsmentioning

confidence: 99%

Vital Signs:Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection — U.S. Territories and Freely Associated States, 2018

Rice¹,

Galang²,

Roth³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

Self Cite

190

237

View full text Add to dashboard Cite

show abstract

“…The birth defects surveillance report identified increased prevalence of birth defects strongly linked to Zika virus infection in 2016 in US areas with local Zika virus transmission. 3 Although these birth defects are not specific to congenital Zika virus infection and have other causes, only those defects found previously to be most closely aligned with congenital Zika infection had increased prevalence. Most of the fetuses and infants described in the birth defects surveillance report had no laboratory evidence of congenital Zika virus infection and no Zika virus testing performed.…”

mentioning

confidence: 86%

“…3 Existing systems were enhanced to identify fetuses and infants with selected birth defects in a timely fashion (Box). The report examines pregnancies completed in 2016, and it included 3 areas with local transmission of Zika virus and areas with higher and lower travel-associated Zika virus disease cases reported.…”

mentioning

confidence: 99%

Birth Defects Potentially Related to Zika Virus Infection During Pregnancy in the United States

Fitzgerald

Boyle

Honein

2018

JAMA

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Zika remains a health threat in the United States, and public health systems are essential to monitoring the full effect of congenital Zika virus infection on infants and children. Because some healthy infants born following pregnancies complicated by Zika may have developmental problems that become evident later, developmental milestones should be closely monitored throughout the child's first years of life.

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“…7 Hoen et al identified only one neural-tube defect in the French territories cohort, which is consistent with growing evidence that neural-tube defects have not increased in areas with local ZIKV transmission and are most likely not caused by ZIKV infection. 8 In the U.S. reports and in the French territories, some brain abnormalities may have been missed among babies whose mothers had confirmed infection, because not all fetuses or infants underwent the recommended brain imaging; continued efforts are needed to increase the proportion of infants who receive all recommended evaluations if their mothers have had evidence of ZIKV infection during pregnancy. 9 …”

mentioning

confidence: 99%

“…Population-level increases in ZIKV-associated birth defects are unlikely to be recognized without ongoing timely and comprehensive surveillance of birth defects that captures all affected fetuses and infants regardless of whether maternal ZIKV exposure or infection was identified. 8 …”

mentioning

confidence: 99%

Recognizing the Global Impact of Zika Virus Infection during Pregnancy

Honein

2018

N Engl J Med

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Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection — 15 States and U.S. Territories, 2016

Cited by 50 publications

References 7 publications

Vital Signs:Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection — U.S. Territories and Freely Associated States, 2018

Vital Signs:Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection — U.S. Territories and Freely Associated States, 2018

Birth Defects Potentially Related to Zika Virus Infection During Pregnancy in the United States

Recognizing the Global Impact of Zika Virus Infection during Pregnancy

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