Zika Virus Disease and Pregnancy Outcomes in Colombia

Ospina, Martha; Tong, Van T.; González, Maribel Castellano; Valencia, Diana; Mercado, Marcela; Gilboa, Suzanne M.; Rodriguez, Andrea J; Tinker, Sarah C.; Rico, Angélica; Winfield, Christina M; Pardo, Lissethe; Thomas, Jennifer D.; Avila, Greace; Villanueva, Julie; Gómez, Sara; Jamieson, Denise J.; Prieto, Franklyn; Meaney‐Delman, Dana; Pacheco, Óscar; Honein, Margaret A.

doi:10.1056/nejmoa1911023

Cited by 50 publications

(50 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The variation in the number of pregnant women in the studies ranged from 28 [ 19 ] to 19,963 [ 39 ]. The overall studies were conducted in the Americas: Brazil [ 25 , 26 , 29 , 33 , 34 , 38 ], Puerto Rico [ 18 ], United States of America (USA) [ 19 , 21 , 22 , 24 , 35 , 37 , 40 ], Peru [ 30 ], French territories of the Americas: French Guiana, Guadeloupe and Martinique [ 20 , 36 ] and Colombia [ 23 , 27 , 28 , 39 ]. Quality scores for the studies are available in S3 Table .…”

Section: Resultsmentioning

confidence: 99%

“…Miscarriage was described in 15 studies [ 18 , 20 – 22 , 24 – 28 , 33 – 37 , 40 ]. The frequency at which miscarriage was reported varied from 0.3% [ 18 ] to 10.6% [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Four studies found no cases of stillbirth [ 19 , 20 , 35 , 37 ] and in those in which it was reported, the frequency varied from 0.78% [ 33 ] to 2.4% [ 34 ]. Small for gestational age (SGA) was reported in three cohorts [ 26 , 30 , 34 ], low birth weigh (LBW) in five studies [ 19 , 23 , 26 – 28 ] and prematurity (PMT) in seven studies [ 19 , 23 , 25 – 28 , 34 ]. The frequency varied: SGA from 1.71% [ 34 ] to 9.09% [ 26 ], LBW from 1.16% [ 23 ] to 9.09% [ 26 ] and PMT from 2.32% [ 23 ] to 14.5% [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

The occurrence of fetal and neonatal disorders in pregnant women with Zika virus infection in the literature is not consistent. This study aims to estimate the prevalence rate of these disorders in fetuses/neonates of pregnant women with confirmed or probable infection by Zika virus. A systematic review with meta-analysis was conducted in November 2020. Cohort studies that contained primary data on the prevalence of unfavorable outcomes in fetuses or neonates of women with confirmed or probable Zika virus infection during pregnancy were included. A total of 21 cohort studies were included, with a total of 35,568 pregnant women. The meta-analysis showed that central nervous system abnormalities had the highest prevalence ratio of 0.06 (95% CI 0.03–0.09). Intracranial calcifications had a prevalence ratio of 0.01 (95% CI 0.01–0.02), and ventriculomegaly 0.01 (95% CI 0.01–0.02). The prevalence ratio of microcephaly was 0.03 (95% CI 0.02–0.05), fetal loss (miscarriage and stillbirth) was 0.04 (95% CI 0.02–0.06), Small for Gestational Age was 0.04 (95% CI 0.00–0,09), Low Birth Weight was 0.05 (95% CI 0.03–0.08) and Prematurity was 0.07 (95% CI 0.04–0.10). The positivity in RT-PCR for ZIKV performed in neonates born to infected mothers during pregnancy was 0.25 (95% CI 0.06–0.44). We also performed the meta-analysis of meta-analysis for microcephaly with the prevalence ratios from other two previously systematic reviews: 0.03 (95% CI 0.00–0.25). Our results contribute to measuring the impact of Zika virus infection during pregnancy on children’s health. The continuous knowledge of this magnitude is essential for the implementation development of health initiatives and programs, in addition to promoting disease prevention, especially in the development of a vaccine for Zika virus. PROSPERO protocol registration: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019125543.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Miscarriage was described in 15 studies [ 18 , 20 – 22 , 24 – 28 , 33 – 37 , 40 ]. The frequency at which miscarriage was reported varied from 0.3% [ 18 ] to 10.6% [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Simulations indicate that surveillance data are generally insufficient to estimate the gestational-age-specific risk of microcephaly, especially given possible changes in reporting that might be caused by an epidemic [ 27 , 28 ]. Birth defect surveillance data from Colombia did indicate a peak in microcephaly (based on diagnosis code) corresponding with the Zika epidemic; however, very large numbers would be needed to detect the observed differences in prevalence (13 cases per 10,000 livebirths during the outbreak, vs. 8 per 10,000 before and 11 per 10,000 after) [ 29 ]. In addition, percentile-based definitions produce a high degree of false positives when compared to truly pathological cases; simulation studies under realistic scenarios estimate <5% positive predictive value [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas

et al. 2020

Self Cite

View full text Add to dashboard Cite

Worldwide recognition of the Zika virus outbreak in the Americas was triggered by an unexplained increase in the frequency of microcephaly. While severe microcephaly is readily identifiable at birth, diagnosing less severe cases requires comparison of head circumference (HC) measurement to a growth chart. We examine measured values of HC and digit preference in those values, and, by extension, the prevalence of microcephaly at birth in two data sources: a research study in Honduras and routine surveillance data in Uruguay. The Zika in Pregnancy in Honduras study enrolled pregnant women prenatally and followed them until delivery. Head circumference was measured with insertion tapes (SECA 212), and instructions including consistent placement of the tape and a request to record HC to the millimeter were posted where newborns were examined. Three indicators of microcephaly were calculated: (1) HC more than 2 standard deviations (SD) below the mean, (2) HC more than 3 SD below the mean (referred to as “severe microcephaly”) and (3) HC less than the 3rd percentile for sex and gestational age, using the INTERGROWTH-21st growth standards. We compared these results from those from a previous analysis of surveillance HC data from the Uruguay Perinatal Information System (Sistema Informático Perinatal (SIP). Valid data on HC were available on 579 infants, 578 with gestational age data. Nine babies (1.56%, 95% CI 0.71–2.93) had HC < 2SD, including two (0.35%, 95% CI 0.04–1.24) with HC < 3SD, and 11 (1.9%, 95% CI, 0.79–3.02) were below the 3rd percentile. The distribution of HC showed strong digit preference: 72% of measures were to the whole centimeter (cm) and 19% to the half-cm. Training and use of insertion tapes had little effect on digit preference, nor were overall HC curves sufficient to detect an increase in microcephaly during the Zika epidemic in Honduras. When microcephaly prevalence needs to be carefully analyzed, such as during the Zika epidemic, researchers may need to interpret HC data with caution.

show abstract

“…During the ZIKV epidemic in Colombia (October 2015 to June 2016), the Colombian National Institute of Health (INS) included ZIKV in its national surveillance system (SIVIGILA) [ 8 , 9 ]. Due to the urgency to understand the impact of in utero ZIKV exposure, INS monitored and evaluated a cohort of infants with prenatal ZIKV exposure from March 2017 to August 2019 through a special ZIKV surveillance program, including enhanced follow-up of pregnant women with ZIKV and their infants.…”

Section: Introductionmentioning

confidence: 99%

Discordant Clinical Outcomes in a Monozygotic Dichorionic-Diamniotic Twin Pregnancy with Probable Zika Virus Exposure. Case Report

Mercado

Daza²,

Moore

et al. 2020

TropicalMed

Self Cite

View full text Add to dashboard Cite

Prenatal exposure to Zika virus (ZIKV) is associated with congenital anomalies of the brain and the eye and neurodevelopmental sequelae. The spectrum of disease outcomes may relate to timing of infection as well as genetic and environmental factors. Congenital infections occurring in twin pregnancies can inform the clinical spectrum of these conditions and provide unique information regarding timing of infection and in utero environment with disease pathophysiology. Herein, we report a monozygotic dichorionic-diamniotic twin pregnancy with probable prenatal ZIKV exposure identified through the Colombian ZIKV disease surveillance system. Multidisciplinary clinical evaluations were provided to the twins during their first three years of life through a national program for children with in utero ZIKV exposure. Laboratory evidence of congenital infection as well as microcephaly, brain, eye, and neurodevelopmental compromise related to prenatal ZIKV infection were identified in only one infant of the twin pregnancy. This is the first report of monozygotic twins discordant for Zika-associated birth defects. The evaluation of the pathophysiology of discordance in disease outcome for congenital infections in twin pregnancies may lead to a better understanding of potential complex environmental and genetic interactions between the mother, her offspring, and an infectious exposure.

show abstract

Zika Virus Disease and Pregnancy Outcomes in Colombia

Cited by 50 publications

References 29 publications

Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis

Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis

Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas

Discordant Clinical Outcomes in a Monozygotic Dichorionic-Diamniotic Twin Pregnancy with Probable Zika Virus Exposure. Case Report

Contact Info

Product

Resources

About