Outcomes of Congenital Zika Virus Infection During an Outbreak in Valle del Cauca, Colombia

Abstract

Background: Despite increasing information in the literature regarding congenital Zika infection, gaps remain in our knowledge of its clinical manifestations. Methods: We did a prospective observational study of exposed fetuses and infants whose mothers developed symptomatic and confirmed Zika infection during pregnancy in Valle del Cauca, Colombia. We performed neurological, ophthalmologic and audiologic evaluations, and classified outcomes as possibly or uncertainly related to Zika. Frequencies of outcomes were compared according to the trimester of pregnancy when infection occurred. Results: We evaluated 171 products of gestation including 17 pregnancy losses and 154 patients evaluated postnatally. Ninety (52.6%) pregnancies presented an adverse outcome, 36% possibly related with Zika and the remaining 64% of uncertain relation. Infection in the first trimester had the highest frequencies of adverse outcomes possibly related with Zika compared with the second and third trimesters (39% vs. 12.5% vs. 12%) with risk ratios of adverse outcomes possibly related to Zika in pregnancies infected in the first versus second or third trimester of 3.1 (95% CI: 2.4–4.1) and 3.3 (95% CI: 2.5–4.2), respectively. The frequencies of pregnancy loss and microcephaly were 9.4% and 4.5%, respectively. Auditory and ophthalmic abnormalities possibly related with Zika were present in 3% and 6% of the patients evaluated, respectively. Conclusions: We observed a high frequency of gestational and neonatal complications in pregnant women who acquired Zika infection, especially in early pregnancy, resulting in a broad spectrum of clinical manifestations. Preventive measures are urgently needed to reduce the clinical burden during future Zika outbreaks.

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

“…Traveller/non-traveller populations: In this update, we found further evidence that congenital abnormalities occurred in infants born to women travellers returning from ZIKV-affected areas and women remaining in those areas. In total, 25 publications report on 272 congenital abnormalities due to ZIKV infection in travellers 27, 29, 30, 32, 34, 36, 38, 42, 45, 56, 58, 61, 89, 94, 98, 109, 117, 122, 123, 137, 140, 151, 153, 166, 173 , with 109 publications reporting congenital abnormalities due to ZIKV in 2652 non travellers 24– 26, 28, 31, 33, 35, 37, 39– 41, 43, 44, 46– 48, 50, 51, 54, 57, 60, 62– 79, 81, 83– 85, 87, 88, 90– 93, 95– 97, 100, 101, 104– 106, 110– 113, 115, 116, 118, 119, 121, 124– 135, 142– 147, 149, 152, 154, 156– 164, 167, 168, 171, 172, 175– 180, 182, …”

A Review of Hearing Loss Associated with Zika, Ebola, and Lassa Fever

“…Across studies, 56 (21.2%) of 264 individuals were found to have some degree of HL. 18,[22][23][24][25][26][27][28][29][30][31][32][33][34] Four of the fourteen articles described acquired HL in adults following Zika infection ( Table 1). The HL in these cases varied from moderate to severe and was reported as both unilateral and bilateral, with most patients experiencing recovery to normal or previous thresholds.…”

“…[22][23][24]30 Ten articles presented complication data of congenital Zika syndrome related to HL (Table 1). 18,22,[25][26][27][28][29][33][34][35] The majority of these studies used standard HL screening methods for infants, including measurement of auditory brainstem response and otoacoustic emission, which assesses cochlear function. 18,[25][26][27][28][29]31,33,34 The proportion of infants with reported HL in these studies varied from 6% to 68%.…”

Patient characteristics and pregnancy outcomes among Zika‐infected pregnant women: Epidemiologic surveillance data from two cities in Colombia, 2015–2016

“…Unfortunately, access to data on the occurrence of congenital malformation was restricted; we were therefore unable to include these data in this analysis, but we hope that it will be published in additional studies conducted by other investigators in the country . Our focus was on observing pregnancy outcomes and on describing the quality of demographic surveillance system data.…”