Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana
| Autor: | Najeh Hcini, Véronique Lambert, Anne Jolivet, David Baud, C. Pomar, Manon Vouga, Alice Panchaud, Léo Pomar, Guillaume Benoist, Gustavo Malinger, Dominique Rousset, Séverine Matheus, Gabriel Carles |
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| Přispěvatelé: | Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Université de Lausanne (UNIL), Centre Hospitalier de l'Ouest Guyanais, Institut pluridisciplinaire de recherche appliquée dans le domaine du génie pétrolier (IPRADDGP), Université de Pau et des Pays de l'Adour (UPPA)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Tel Aviv University [Tel Aviv], University of Geneva [Switzerland], Gestionnaire, Hal Sorbonne Université, Université de Lausanne = University of Lausanne (UNIL), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Tel Aviv University (TAU), Tel Aviv Sourasky Medical Center [Te Aviv], Université de Genève = University of Geneva (UNIGE), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), We thank all involved personnel at the Centre Hospitalier de l'Ouest Guyannais (CHOG)., Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
MESH: Pregnancy Complications
Infectious* / epidemiology MESH: Risk Assessment MESH: Zika Virus Infection / congenital Zika virus 0302 clinical medicine MESH: Pregnancy Pregnancy [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases 030212 general & internal medicine Prospective Studies Pregnancy Complications Infectious Prospective cohort study ComputingMilieux_MISCELLANEOUS education.field_of_study [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases 030219 obstetrics & reproductive medicine biology Obstetrics Zika Virus Infection MESH: Infant Newborn MESH: Infectious Disease Transmission Vertical Pregnancy Outcome General Medicine MESH: Zika Virus Infection / transmission 3. Good health French Guiana MESH: Young Adult Cohort [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases Female medicine.symptom Cohort study Adult medicine.medical_specialty Population Prenatal diagnosis [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics Asymptomatic Risk Assessment 03 medical and health sciences Young Adult MESH: French Guiana medicine Humans education Epidemics MESH: Epidemics MESH: Humans business.industry Research Infant Newborn MESH: Adult [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry Molecular Biology/Molecular biology biology.organism_classification medicine.disease MESH: Pregnancy Outcome MESH: Prospective Studies Infectious Disease Transmission Vertical [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business MESH: Zika Virus Infection / epidemiology MESH: Female |
| Zdroj: | BMJ BMJ, BMJ Publishing Group, 2018, pp.k4431. ⟨10.1136/bmj.k4431⟩ The BMJ BMJ, 2018, 363, pp.k4431. ⟨10.1136/bmj.k4431⟩ BMJ, BMJ Publishing Group, 2018, 363, pp.k4431. ⟨10.1136/bmj.k4431⟩ |
| ISSN: | 0959-8138 1468-5833 |
| DOI: | 10.1136/bmj.k4431⟩ |
| Popis: | ObjectivesTo estimate the rates of maternal-fetal transmission of Zika virus, adverse fetal/neonatal outcomes, and subsequent rates of asymptomatic/symptomatic congenital Zika virus infections up to the first week of life.DesignCohort study with prospective data collection and subsequent review of fetal/neonatal outcomes.SettingsReferral centre for prenatal diagnosis of the French Guiana Western Hospital.ParticipantsPregnant women at any stage of pregnancy with a laboratory confirmed symptomatic or asymptomatic Zika virus infection during the epidemic period in western French Guiana. The cohort enrolled 300 participants and prospectively followed their 305 fetuses/newborns.Main outcome measuresRate of maternal-fetal transmission of Zika virus (amniotic fluid, fetal and neonatal blood, urine, cerebrospinal fluid, and placentas); clinical, biological, and radiological outcomes (blindly reviewed); and adverse outcomes defined as moderate signs potentially related to congenital Zika syndrome (CZS), severe complications compatible with CZS, or fetal loss. Associations between a laboratory confirmed congenital Zika virus infection and adverse fetal/neonatal outcomes were evaluated.ResultsMaternal-fetal transmission was documented in 26% (76/291) of fetuses/newborns with complete data. Among the Zika virus positive fetuses/newborns, 45% (34/76) presented with no signs/complications at birth, 20% (15/76) with moderate signs potentially related to CZS, 21% (16/76) with severe complications compatible with CZS, and 14% (11/76) with fetal loss. Compared with the Zika virus positive fetuses/neonates, those that were identified as negative for Zika virus (215/291) were less likely to present with severe complications (5%; 10/215) or fetal loss (0.5%; 1/215; relative risk 6.9, 95% confidence interval 3.6 to 13.3). Association between a positive Zika virus test and any adverse fetal/neonatal outcome was also significant (relative risk 4.4, 2.9 to 6.6). The population attributable fraction estimates that a confirmed congenital Zika virus infection contributes to 47% of adverse outcomes and 61% of severe adverse outcomes observed.ConclusionIn cases of a known maternal Zika virus infection, approximately a quarter of fetuses will become congenitally infected, of which a third will have severe complications at birth or fetal loss. The burden of CZS might be lower than initially described in South America and may not differ from other congenital infections. |
| Databáze: | OpenAIRE |
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