Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil

M. L. Nogueira, N. R.R. Nery Júnior, C. F. Estofolete, A. C. Bernardes Terzian, G. F. Guimarães, N. Zini, R. Alves da Silva, G. C. Dutra Silva, L. C. Junqueira Franco, P. Rahal, C. Bittar, B. Carneiro, P. F.C. Vasconcelos, D. Freitas Henriques, D. M.U. Barbosa, P. Lopes Rombola, L. de Grande, A. F. Negri Reis, S. A. Palomares, M. Wakai Catelan & 14 others L. E.A.A. Cruz, S. H. Necchi, R. C.V. Mendonça, I. N. Penha dos Santos, S. B. Alavarse Caron, F. Costa, F. A. Bozza, A. Soares de Souza, C. C. Brandão de Mattos, L. C. de Mattos, Nikos Vasilakis, A. H. Oliani, D. C.M. Vaz Oliani, A. I. Ko

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: We aimed to report the first 54 cases of pregnant women infected by Zika virus (ZIKV) and their virologic and clinical outcomes, as well as their newborns’ outcomes, in 2016, after the emergence of ZIKV in dengue-endemic areas of São Paulo, Brazil. Methods: This descriptive study was performed from February to October 2016 on 54 quantitative real-time PCR ZIKV-positive pregnant women identified by the public health authority of São José do Rio Preto, São Paulo, Brazil. The women were followed and had clinical and epidemiologic data collected before and after birth. Adverse outcomes in newborns were analysed and reported. Urine or blood samples from newborns were collected to identify ZIKV infection by reverse transcription PCR (RT-PCR). Results: A total of 216 acute Zika-suspected pregnant women were identified, and 54 had the diagnosis confirmed by RT-PCR. None of the 54 women miscarried. Among the 54 newborns, 15 exhibited adverse outcomes at birth. The highest number of ZIKV infections occurred during the second and third trimesters. No cases of microcephaly were reported, though a broad clinical spectrum of outcomes, including lenticulostriate vasculopathy, subependymal cysts, and auditory and ophthalmologic disorders, were identified. ZIKV RNA was detected in 18 of 51 newborns tested and in eight of 15 newborns with adverse outcomes. Conclusions: Although other studies have associated many newborn outcomes to ZIKV infection during pregnancy, these same adverse outcomes were rare or nonexistent in this study. The clinical presentation the newborns we studied was mild compared to other reports, suggesting that there is significant heterogeneity in congenital Zika infection.

Original languageEnglish (US)
Pages (from-to)646-652
Number of pages7
JournalClinical Microbiology and Infection
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2018

Fingerprint

Brazil
Parturition
Newborn Infant
Pregnancy
Pregnant Women
Basal Ganglia Cerebrovascular Disease
Reverse Transcription
Polymerase Chain Reaction
Microcephaly
Dengue
Zika Virus
Third Pregnancy Trimester
Second Pregnancy Trimester
Cysts
Real-Time Polymerase Chain Reaction
Public Health
Urine
RNA
Infection
Zika Virus Infection

Keywords

  • Adverse outcome
  • Arbovirus
  • Birth
  • Pregnancy
  • Zika virus

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Nogueira, M. L., Nery Júnior, N. R. R., Estofolete, C. F., Bernardes Terzian, A. C., Guimarães, G. F., Zini, N., ... Ko, A. I. (2018). Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil. Clinical Microbiology and Infection, 24(6), 646-652. https://doi.org/10.1016/j.cmi.2017.11.004

Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil. / Nogueira, M. L.; Nery Júnior, N. R.R.; Estofolete, C. F.; Bernardes Terzian, A. C.; Guimarães, G. F.; Zini, N.; Alves da Silva, R.; Dutra Silva, G. C.; Junqueira Franco, L. C.; Rahal, P.; Bittar, C.; Carneiro, B.; Vasconcelos, P. F.C.; Freitas Henriques, D.; Barbosa, D. M.U.; Lopes Rombola, P.; de Grande, L.; Negri Reis, A. F.; Palomares, S. A.; Wakai Catelan, M.; Cruz, L. E.A.A.; Necchi, S. H.; Mendonça, R. C.V.; Penha dos Santos, I. N.; Alavarse Caron, S. B.; Costa, F.; Bozza, F. A.; Soares de Souza, A.; Brandão de Mattos, C. C.; de Mattos, L. C.; Vasilakis, Nikos; Oliani, A. H.; Vaz Oliani, D. C.M.; Ko, A. I.

In: Clinical Microbiology and Infection, Vol. 24, No. 6, 01.06.2018, p. 646-652.

Research output: Contribution to journalArticle

Nogueira, ML, Nery Júnior, NRR, Estofolete, CF, Bernardes Terzian, AC, Guimarães, GF, Zini, N, Alves da Silva, R, Dutra Silva, GC, Junqueira Franco, LC, Rahal, P, Bittar, C, Carneiro, B, Vasconcelos, PFC, Freitas Henriques, D, Barbosa, DMU, Lopes Rombola, P, de Grande, L, Negri Reis, AF, Palomares, SA, Wakai Catelan, M, Cruz, LEAA, Necchi, SH, Mendonça, RCV, Penha dos Santos, IN, Alavarse Caron, SB, Costa, F, Bozza, FA, Soares de Souza, A, Brandão de Mattos, CC, de Mattos, LC, Vasilakis, N, Oliani, AH, Vaz Oliani, DCM & Ko, AI 2018, 'Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil', Clinical Microbiology and Infection, vol. 24, no. 6, pp. 646-652. https://doi.org/10.1016/j.cmi.2017.11.004
Nogueira ML, Nery Júnior NRR, Estofolete CF, Bernardes Terzian AC, Guimarães GF, Zini N et al. Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil. Clinical Microbiology and Infection. 2018 Jun 1;24(6):646-652. https://doi.org/10.1016/j.cmi.2017.11.004
Nogueira, M. L. ; Nery Júnior, N. R.R. ; Estofolete, C. F. ; Bernardes Terzian, A. C. ; Guimarães, G. F. ; Zini, N. ; Alves da Silva, R. ; Dutra Silva, G. C. ; Junqueira Franco, L. C. ; Rahal, P. ; Bittar, C. ; Carneiro, B. ; Vasconcelos, P. F.C. ; Freitas Henriques, D. ; Barbosa, D. M.U. ; Lopes Rombola, P. ; de Grande, L. ; Negri Reis, A. F. ; Palomares, S. A. ; Wakai Catelan, M. ; Cruz, L. E.A.A. ; Necchi, S. H. ; Mendonça, R. C.V. ; Penha dos Santos, I. N. ; Alavarse Caron, S. B. ; Costa, F. ; Bozza, F. A. ; Soares de Souza, A. ; Brandão de Mattos, C. C. ; de Mattos, L. C. ; Vasilakis, Nikos ; Oliani, A. H. ; Vaz Oliani, D. C.M. ; Ko, A. I. / Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil. In: Clinical Microbiology and Infection. 2018 ; Vol. 24, No. 6. pp. 646-652.
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abstract = "Objectives: We aimed to report the first 54 cases of pregnant women infected by Zika virus (ZIKV) and their virologic and clinical outcomes, as well as their newborns’ outcomes, in 2016, after the emergence of ZIKV in dengue-endemic areas of S{\~a}o Paulo, Brazil. Methods: This descriptive study was performed from February to October 2016 on 54 quantitative real-time PCR ZIKV-positive pregnant women identified by the public health authority of S{\~a}o Jos{\'e} do Rio Preto, S{\~a}o Paulo, Brazil. The women were followed and had clinical and epidemiologic data collected before and after birth. Adverse outcomes in newborns were analysed and reported. Urine or blood samples from newborns were collected to identify ZIKV infection by reverse transcription PCR (RT-PCR). Results: A total of 216 acute Zika-suspected pregnant women were identified, and 54 had the diagnosis confirmed by RT-PCR. None of the 54 women miscarried. Among the 54 newborns, 15 exhibited adverse outcomes at birth. The highest number of ZIKV infections occurred during the second and third trimesters. No cases of microcephaly were reported, though a broad clinical spectrum of outcomes, including lenticulostriate vasculopathy, subependymal cysts, and auditory and ophthalmologic disorders, were identified. ZIKV RNA was detected in 18 of 51 newborns tested and in eight of 15 newborns with adverse outcomes. Conclusions: Although other studies have associated many newborn outcomes to ZIKV infection during pregnancy, these same adverse outcomes were rare or nonexistent in this study. The clinical presentation the newborns we studied was mild compared to other reports, suggesting that there is significant heterogeneity in congenital Zika infection.",
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T1 - Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil

AU - Nogueira, M. L.

AU - Nery Júnior, N. R.R.

AU - Estofolete, C. F.

AU - Bernardes Terzian, A. C.

AU - Guimarães, G. F.

AU - Zini, N.

AU - Alves da Silva, R.

AU - Dutra Silva, G. C.

AU - Junqueira Franco, L. C.

AU - Rahal, P.

AU - Bittar, C.

AU - Carneiro, B.

AU - Vasconcelos, P. F.C.

AU - Freitas Henriques, D.

AU - Barbosa, D. M.U.

AU - Lopes Rombola, P.

AU - de Grande, L.

AU - Negri Reis, A. F.

AU - Palomares, S. A.

AU - Wakai Catelan, M.

AU - Cruz, L. E.A.A.

AU - Necchi, S. H.

AU - Mendonça, R. C.V.

AU - Penha dos Santos, I. N.

AU - Alavarse Caron, S. B.

AU - Costa, F.

AU - Bozza, F. A.

AU - Soares de Souza, A.

AU - Brandão de Mattos, C. C.

AU - de Mattos, L. C.

AU - Vasilakis, Nikos

AU - Oliani, A. H.

AU - Vaz Oliani, D. C.M.

AU - Ko, A. I.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Objectives: We aimed to report the first 54 cases of pregnant women infected by Zika virus (ZIKV) and their virologic and clinical outcomes, as well as their newborns’ outcomes, in 2016, after the emergence of ZIKV in dengue-endemic areas of São Paulo, Brazil. Methods: This descriptive study was performed from February to October 2016 on 54 quantitative real-time PCR ZIKV-positive pregnant women identified by the public health authority of São José do Rio Preto, São Paulo, Brazil. The women were followed and had clinical and epidemiologic data collected before and after birth. Adverse outcomes in newborns were analysed and reported. Urine or blood samples from newborns were collected to identify ZIKV infection by reverse transcription PCR (RT-PCR). Results: A total of 216 acute Zika-suspected pregnant women were identified, and 54 had the diagnosis confirmed by RT-PCR. None of the 54 women miscarried. Among the 54 newborns, 15 exhibited adverse outcomes at birth. The highest number of ZIKV infections occurred during the second and third trimesters. No cases of microcephaly were reported, though a broad clinical spectrum of outcomes, including lenticulostriate vasculopathy, subependymal cysts, and auditory and ophthalmologic disorders, were identified. ZIKV RNA was detected in 18 of 51 newborns tested and in eight of 15 newborns with adverse outcomes. Conclusions: Although other studies have associated many newborn outcomes to ZIKV infection during pregnancy, these same adverse outcomes were rare or nonexistent in this study. The clinical presentation the newborns we studied was mild compared to other reports, suggesting that there is significant heterogeneity in congenital Zika infection.

AB - Objectives: We aimed to report the first 54 cases of pregnant women infected by Zika virus (ZIKV) and their virologic and clinical outcomes, as well as their newborns’ outcomes, in 2016, after the emergence of ZIKV in dengue-endemic areas of São Paulo, Brazil. Methods: This descriptive study was performed from February to October 2016 on 54 quantitative real-time PCR ZIKV-positive pregnant women identified by the public health authority of São José do Rio Preto, São Paulo, Brazil. The women were followed and had clinical and epidemiologic data collected before and after birth. Adverse outcomes in newborns were analysed and reported. Urine or blood samples from newborns were collected to identify ZIKV infection by reverse transcription PCR (RT-PCR). Results: A total of 216 acute Zika-suspected pregnant women were identified, and 54 had the diagnosis confirmed by RT-PCR. None of the 54 women miscarried. Among the 54 newborns, 15 exhibited adverse outcomes at birth. The highest number of ZIKV infections occurred during the second and third trimesters. No cases of microcephaly were reported, though a broad clinical spectrum of outcomes, including lenticulostriate vasculopathy, subependymal cysts, and auditory and ophthalmologic disorders, were identified. ZIKV RNA was detected in 18 of 51 newborns tested and in eight of 15 newborns with adverse outcomes. Conclusions: Although other studies have associated many newborn outcomes to ZIKV infection during pregnancy, these same adverse outcomes were rare or nonexistent in this study. The clinical presentation the newborns we studied was mild compared to other reports, suggesting that there is significant heterogeneity in congenital Zika infection.

KW - Adverse outcome

KW - Arbovirus

KW - Birth

KW - Pregnancy

KW - Zika virus

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