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The article presents a report which estimated the prevalence of autism spectrum disorder (ASD) diagnoses among children with possible prenatal Zika virus exposure and described prenatal characteristics and other outcomes by ASD diagnosis status. Topics include possible effects of infection during pregnancy with Zika virus, prevalence of ASD diagnosis among children with Zika virus exposure reported from Puerto Rico, and prenatal characteristics and child outcomes among live-born infants.

Background: Multiple reports have described neonatal SARS‐CoV‐2 infection, including likely in utero transmission and early postnatal infection, but published estimates of neonatal infection range by geography and design type. Objectives: To describe maternal, pregnancy and neonatal characteristics among neonates born to people with SARS‐CoV‐2 infection during pregnancy by neonatal SARS‐CoV‐2 testing results. Methods: Using aggregated data from the Surveillance for Emerging Threats to Mothers and Babies Network (SET‐NET) describing infections from 20 January 2020 to 31 December 2020, we identified neonates who were (1) born to people who were SARS‐CoV‐2 positive by RT‐PCR at any time during their pregnancy, and (2) tested for SARS‐CoV‐2 by RT‐PCR during the birth hospitalisation. Results: Among 28,771 neonates born to people with SARS‐CoV‐2 infection during pregnancy, 3816 (13%) underwent PCR testing and 138 neonates (3.6%) were PCR positive. Ninety‐four per cent of neonates testing positive were born to people with infection identified ≤14 days of delivery. Neonatal SARS‐CoV‐2 infection was more frequent among neonates born preterm (5.7%) compared to term (3.4%). Neonates testing positive were born to both symptomatic and asymptomatic pregnant people. Conclusions: Jurisdictions reported SARS‐CoV‐2 RT‐PCR results for only 13% of neonates known to be born to people with SARS‐CoV‐2 infection during pregnancy. These results provide evidence of neonatal infection identified through multi‐state systematic surveillance data collection and describe characteristics of neonates with SARS‐CoV‐2 infection. While perinatal SARS‐CoV‐2 infection was uncommon among tested neonates born to people with SARS‐CoV‐2 infection during pregnancy, nearly all cases of tested neonatal infection occurred in pregnant people infected around the time of delivery and was more frequent among neonates born preterm. These findings support the recommendation for neonatal SARS‐CoV‐2 RT‐PCR testing, especially for people with acute infection around the time of delivery. [ABSTRACT FROM AUTHOR]

Background: The US Zika Pregnancy and Infant Registry (USZPIR) monitors infants born to mothers with confirmed or possible Zika virus infection during pregnancy. The surveillance case definition for Zika‐associated birth defects includes microcephaly based on head circumference (HC). Methods: We assessed birth and follow‐up data from infants with birth HC measurements <3rd percentile and birthweight ≥10th percentile to determine possible misclassification of microcephaly. We developed a schema informed by literature review and expert opinion to identify possible HC measurement inaccuracy using HC growth velocity and longitudinal HC measurements between 2 and 12 months of age. Two or more HC measurements were required for assessment. Inaccuracy in birth HC measurement was suspected if growth velocity was >3 cm/month in the first 3 months or HC was consistently >25th percentile during follow‐up. Results: Of 6,799 liveborn infants in USZPIR, 351 (5.2%) had Zika‐associated birth defects, of which 111 had birth HC measurements <3rd percentile and birthweight ≥10th percentile. Of 84/111 infants with sufficient follow‐up, 38/84 (45%) were classified as having possible inaccuracy of birth HC measurement, 19/84 (23%) had HC ≥3rd percentile on follow‐up without meeting criteria for possible inaccuracy, and 27/84 (32%) had continued HC <3rd percentile. After excluding possible inaccuracies, the proportion of infants with Zika‐associated birth defects including microcephaly decreased from 5.2% to 4.6%. Conclusions: About one‐third of infants in USZPIR with Zika‐associated birth defects had only microcephaly, but indications of possible measurement inaccuracy were common. Implementation of this schema in longitudinal studies can reduce misclassification of microcephaly. [ABSTRACT FROM AUTHOR]

Introduction: Zika 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.Methods: Pregnancies 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.Results: Among 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.Conclusion: One 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. [ABSTRACT FROM AUTHOR]