Hematological Profile of Pregnant Women with Suspected Zika Virus Infection Followed Up at a Referral Service in Manaus, Brazil.

Anny Beatriz Costa Antony De Andrade,Flor Ernestina Martinez-Espinosa,Maria Jacirema Ferreira Gonçalves,Maria Das Graças Costa Alecrim,Elijane De Fátima Redivo

doi:10.3390/v13040710

Anny Beatriz Costa Antony De Andrade, Flor Ernestina Martinez-Espinosa + Show 3 more

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https://doi.org/10.3390/v13040710

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Abstract

The purpose of this paper is to describe the hematological profile of pregnant women with suspected Zika virus (ZIKV) infection followed up at a reference service for infectious diseases in Manaus, Brazil, through a clinical, epidemiological, cross-sectional study of pregnant women with an exanthematic manifestation who looked for care between 2015 and 2017. The participants were 499 pregnant women, classified into four subgroups, according to laboratory confirmation of infections: ZIKV-positive; ZIKV-positive and positive for another infection; positive for another infection but not ZIKV-positive; and not positive for any of the infections investigated. Hematological parameters were analyzed descriptively. The association between maternal infection and the hematological profile, along with the association between the maternal hematological profile and the gestational outcome, were tested. Similar hematic and platelet parameters were observed among pregnant women. However, a significant association was observed between low maternal lymphocyte count and a positive diagnosis for ZIKV (p < 0.001). The increase in maternal platelet count and the occurrence of unfavorable gestational outcome were positively associated. A similar hematic and platelet profile was identified among pregnant women, differing only in the low lymphocyte count among ZIKV-positive pregnant women. Regarding gestational outcomes, in addition to the damage caused by ZIKV infection, altered maternal platelets may lead to unfavorable outcomes, with the need for adequate follow-up during prenatal care.

Highlights

Zika virus (ZIKV) infection is a 21st century health emergency, which was declared as such by the World Health Organization [1]
The relationship between ZIKV infection during pregnancy and the occurrence of deleterious outcomes should take into account changes in the maternal condition that might affect the maintenance of the pregnancy [4,5]
The aim of this study is to describe the hematological profile of pregnant women with suspected ZIKV infection followed up in a reference service for infectious diseases in Manaus, the capital of Amazonas, in northern Brazil

Summary

Introduction

Zika virus (ZIKV) infection is a 21st century health emergency, which was declared as such by the World Health Organization [1]. It is associated with altered development in children exposed to infection during the maternal gestational period [2]. The relationship between ZIKV infection during pregnancy and the occurrence of deleterious outcomes should take into account changes in the maternal condition that might affect the maintenance of the pregnancy [4,5]. In addition to changes inherent to the gestational period, such as hemodilution and thrombocytopenia [8,9,10], hematological changes can be triggered by infections. Erythropenia, leukopenia, and thrombocytopenia have been observed in pregnant women affected by other arboviruses, such as the Dengue (DENV) and Chikungunya (CHIKV)

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