Zika Virus Infection in Pregnant Women in Rio de Janeiro
| Autor: | Patrícia Brasil, José P. Pereira, M. Elisabeth Moreira, Rita M. Ribeiro Nogueira, Luana Damasceno, Mayumi Wakimoto, Renata S. Rabello, Stephanie G. Valderramos, Umme-Aiman Halai, Tania S. Salles, Andrea A. Zin, Dafne Horovitz, Pedro Daltro, Marcia Boechat, Claudia Raja Gabaglia, Patrícia Carvalho de Sequeira, José H. Pilotto, Raquel Medialdea-Carrera, Denise Cotrim da Cunha, Liege M. Abreu de Carvalho, Marcos Pone, André Machado Siqueira, Guilherme A. Calvet, Ana E. Rodrigues Baião, Elizabeth S. Neves, Paulo R. Nassar de Carvalho, Renata H. Hasue, Peter B. Marschik, Christa Einspieler, Carla Janzen, James D. Cherry, Ana M. Bispo de Filippis, Karin Nielsen-Saines |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Zika virus disease Adult Central Nervous System medicine.medical_specialty Adolescent Gestational Age Rubella Ultrasonography Prenatal Zika virus 03 medical and health sciences Young Adult 0302 clinical medicine Fetus Pregnancy Epidemiology Maculopapular rash Medicine Humans 030212 general & internal medicine Pregnancy Complications Infectious Fetal Death Fetal Growth Retardation biology business.industry Obstetrics Zika Virus Infection Brain General Medicine Zika Virus Middle Aged medicine.disease biology.organism_classification Rash Surgery 030104 developmental biology Premature birth Microcephaly Premature Birth Female medicine.symptom business Brazil |
| Zdroj: | The New England journal of medicine. 375(24) |
| ISSN: | 1533-4406 |
| Popis: | Zika virus (ZIKV) has been linked to central nervous system malformations in fetuses. To characterize the spectrum of ZIKV disease in pregnant women and infants, we followed patients in Rio de Janeiro to describe clinical manifestations in mothers and repercussions of acute ZIKV infection in infants.We enrolled pregnant women in whom a rash had developed within the previous 5 days and tested blood and urine specimens for ZIKV by reverse-transcriptase-polymerase-chain-reaction assays. We followed women prospectively to obtain data on pregnancy and infant outcomes.A total of 345 women were enrolled from September 2015 through May 2016; of these, 182 women (53%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 6 to 39 weeks of gestation. Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). By July 2016, a total of 134 ZIKV-affected pregnancies and 73 ZIKV-unaffected pregnancies had reached completion, with outcomes known for 125 ZIKV-affected and 61 ZIKV-unaffected pregnancies. Infection with chikungunya virus was identified in 42% of women without ZIKV infection versus 3% of women with ZIKV infection (P0.001). Rates of fetal death were 7% in both groups; overall adverse outcomes were 46% among offspring of ZIKV-positive women versus 11.5% among offspring of ZIKV-negative women (P0.001). Among 117 live infants born to 116 ZIKV-positive women, 42% were found to have grossly abnormal clinical or brain imaging findings or both, including 4 infants with microcephaly. Adverse outcomes were noted regardless of the trimester during which the women were infected with ZIKV (55% of pregnancies had adverse outcomes after maternal infection in the first trimester, 52% after infection in the second trimester, and 29% after infection in the third trimester).Despite mild clinical symptoms in the mother, ZIKV infection during pregnancy is deleterious to the fetus and is associated with fetal death, fetal growth restriction, and a spectrum of central nervous system abnormalities. (Funded by Ministério da Saúde do Brasil and others.). |
| Databáze: | OpenAIRE |
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