The Effects of Zika in Pregnancy: The Miami Experience [20M

Abstract

INTRODUCTION: Zika virus infection in pregnancy is a global health concern. Obstetric providers in Miami care for a large numbers of pregnant women with suspected or confirmed infection from Zika-affected countries, as well as the first cases of local transmission in the United States. We are uniquely positioned to contribute data on the characteristics of Zika-infected pregnant women delivering in the US. METHODS: After receiving IRB approval a retrospective chart review was conducted. Using laboratory records of Zika testing (PCR and IgM) performed from January through September 2016 at multiple tertiary care centers in Miami, we extracted demographic data from all pregnant women with PCR and/or IgM tests positive for Zika virus. Testing was based on CDC guidelines at the time of testing, leading to heterogeneity in testing. Routine obstetrics parameters and presence of fetal or neonatal abnormalities were noted. RESULTS: A total of 997 pregnant women were tested for Zika. Of those screened, 32 had positive Zika IgM or PCR testing in serum or urine. At the time of writing, 23 had delivered. 2 had microcephaly based on CDC diagnostic criteria. 1 had abnormal intracranial findings and 6 had abnormal fetal ultrasounds prior to delivery. Of those who were still pregnant at the time of writing, 1 had fetal ultrasounds with abnormalities. CONCLUSION: In Miami we have a large population of women with Zika virus exposure in pregnancy. With a mix of local and remote infections, our group represents a diverse cohort from whom we can contribute a broad understanding of pregnancy implications.