1. Maternal Zika Virus Disease Severity, Virus Load, Prior Dengue Antibodies, and Their Relationship to Birth Outcomes
- Author
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Halai, Umme-Aiman, Nielsen-Saines, Karin, Moreira, Maria Lopes, de Sequeira, Patricia Carvalho, Pereira, Jose Paulo, de Araujo Zin, Andrea, Cherry, James, Gabaglia, Claudia Raja, Gaw, Stephanie L, Adachi, Kristina, Tsui, Irena, Pilotto, Jose Henrique, Nogueira, Rita Ribeiro, de Filippis, Ana Maria Bispo, and Brasil, Patricia
- Subjects
Reproductive Medicine ,Biomedical and Clinical Sciences ,Women's Health ,Clinical Research ,Infectious Diseases ,Emerging Infectious Diseases ,Biodefense ,Vector-Borne Diseases ,Conditions Affecting the Embryonic and Fetal Periods ,Perinatal Period - Conditions Originating in Perinatal Period ,Rare Diseases ,Pediatric ,Pregnancy ,4.1 Discovery and preclinical testing of markers and technologies ,2.1 Biological and endogenous factors ,Infection ,Reproductive health and childbirth ,Good Health and Well Being ,Adolescent ,Adult ,Antibodies ,Viral ,Brain ,Brazil ,Dengue Virus ,Female ,Fetal Death ,Humans ,Live Birth ,Middle Aged ,Nervous System Diseases ,Nervous System Malformations ,Neuroimaging ,Neurologic Examination ,Pregnancy Complications ,Infectious ,Prospective Studies ,RNA ,Viral ,Severity of Illness Index ,Viral Load ,Young Adult ,Zika Virus ,Zika Virus Infection ,Zika ,dengue ,ZIKV ,pregnancy ,congenital ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundCongenital Zika virus (ZIKV) syndrome is a newly identified condition resulting from infection during pregnancy. We analyzed outcome data from a mother-infant cohort in Rio de Janeiro in order to assess whether clinical severity of maternal ZIKV infection was associated with maternal virus load, prior dengue antibodies, or abnormal pregnancy/infant outcomes.MethodsA clinical severity assessment tool was developed based on duration of fever, severity of rash, multisystem involvement, and duration of symptoms during ZIKV infection. ZIKV-RNA load was quantified by polymerase chain reaction (PCR) cycles in blood/ urine. Dengue immunoglobulin G (IgG) antibodies were measured at baseline. Adverse outcomes were defined as fetal loss or a live infant with grossly abnormal clinical or brain imaging findings. Regression models were used to study potential associations.Results131 ZIKV-PCR positive pregnant women were scored for clinical disease severity, 6 (4.6%) had mild disease, 98 (74.8%) had moderate disease, and 27 (20.6%) severe manifestations of ZIKV infection. There were 58 (46.4%) abnormal outcomes with 9 fetal losses (7.2%) in 125 pregnancies. No associations were found between: disease severity and abnormal outcomes (P = .961; odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.796-1.270); disease severity and viral load (P = .994); viral load and adverse outcomes (P = .667; OR: 1.02; 95% CI: 0.922-1.135); or existence of prior dengue antibodies (88% subjects) with severity score, ZIKV-RNA load or adverse outcomes (P = .667; OR: 0.78; 95% CI: 0.255-2.397).ConclusionsCongenital ZIKV syndrome does not appear to be associated with maternal disease severity, ZIKV-RNA load at time of infection or existence of prior dengue antibodies.
- Published
- 2017