Abstract
Project Vigilancia de Embarazadas con Zika (VEZ), an intensified surveillance of pregnant women with symptoms of the Zika virus disease (ZVD) in Colombia, aimed to evaluate the relationship between symptoms of ZVD during pregnancy and adverse pregnancy, birth, and infant outcomes and early childhood neurodevelopmental outcomes. During May–November 2016, pregnant women in three Colombian cities who were reported with symptoms of ZVD to the national surveillance system, or with symptoms of ZVD visiting participating clinics, were enrolled in Project VEZ. Data from maternal and pediatric (up to two years of age) medical records were abstracted. Available maternal specimens were tested for the presence of the Zika virus ribonucleic acid and/or anti-Zika virus immunoglobulin antibodies. Of 1213 enrolled pregnant women with symptoms of ZVD, 1180 had a known pregnancy outcome. Results of the Zika virus laboratory testing were available for 569 (48.2%) pregnancies with a known pregnancy outcome though testing timing varied and was often distal to the timing of symptoms; 254 (21.5% of the whole cohort; 44.6% of those with testing results) were confirmed or presumptive positive for the Zika virus infection. Of pregnancies with a known outcome, 50 (4.2%) fetuses/infants had Zika-associated brain or eye defects, which included microcephaly at birth. Early childhood adverse neurodevelopmental outcomes were more common among those with Zika-associated birth defects than among those without and more common among those with laboratory evidence of a Zika virus infection compared with the full cohort. The proportion of fetuses/infants with any Zika-associated brain or eye defect was consistent with the proportion seen in other studies. Enhancements to Colombia’s existing national surveillance enabled the assessment of adverse outcomes associated with ZVD in pregnancy.
Highlights
The Zika virus is a flavivirus transmitted to humans primarily by the bite of infected mosquitoes of the Aedes Stegomyia species [1] and can cause fever, rash, and joint pain in infected individuals
The definition of follow-up was the presence of clinical information in the medical record after two weeks post-birth. Among this group of children, we explored early childhood neurodevelopmental outcomes
Characteristics of the subcohort with laboratory evidence of a Zika virus infection were similar to the entire cohort (Table 1)
Summary
The Zika virus is a flavivirus transmitted to humans primarily by the bite of infected mosquitoes of the Aedes Stegomyia species [1] and can cause fever, rash, and joint pain in infected individuals. A congenital Zika virus infection can cause microcephaly and severe birth defects of the brain and eye [4,5,6,7] and has been associated with neurodevelopmental abnormalities in the child, such as seizures, joint contractures, swallowing difficulties, vision impairments, hearing loss, and delayed achievement of developmental milestones [4,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. Among them were 18,117 pregnant women; one-third of symptomatic ZVD cases in pregnant women in Colombia were laboratory-confirmed with the Zika virus infection [24]
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