Microcephaly Outcomes among Zika Virus-Infected Pregnant Women in Honduras

Abstract

The impact of Zika virus (ZIKV) infection on pregnancies shows regional variation emphasizing the importance of studies in different geographical areas. We conducted a prospective study in Tegucigalpa, Honduras, recruiting 668 pregnant women between July 20, 2016, and December 31, 2016. We performed Trioplex real-time reverse transcriptase-PCR (rRT-PCR) in 357 serum samples taken at the first prenatal visit. The presence of ZIKV was confirmed in seven pregnancies (7/357, 2.0%). Nine babies (1.6%) had microcephaly (head circumference more than two SDs below the mean), including two (0.3%) with severe microcephaly (head circumference [HC] more than three SDs below the mean). The mothers of both babies with severe microcephaly had evidence of ZIKV infection. A positive ZIKV Trioplex rRT-PCR was associated with a 33.3% (95% CI: 4.3-77.7%) risk of HC more than three SDs below the mean.

Figure 1.

Number (n) of suspected cases of ZIKV infections reported in the Tegucigalpa metropolitan area (Región Sanitaria Metropolitana del Distrito Central), January–December 2016 (epidemiological weeks 1–52). The Zika in Pregnancy in Honduras (ZIPH) study started on week 28. Crosses (+) denote Trioplex rRT-PCR assays positive for ZIKV among ZIPH participants. Crosses in a dotted line box denote both rRT-PCR assay and head circumference more than three SDs below the mean. rRT-PCR = real-time reverse transcriptase–PCR; ZIKV = Zika virus. This figure appears in color at www.ajtmh.org.