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. 2023 May 5;13(1):7335.
doi: 10.1038/s41598-023-33334-5.

Risk of adverse pregnancy and infant outcomes associated with prenatal Zika virus infection: a post-epidemic cohort in Central-West Brazil

Luiza Emylce Pela Rosado  1   2 , Celina M Turchi Martelli  3 , Elizabeth B Brickley  4 , Maria Barbara Franco Gomes  5   6 , Talita de Toledo Lima  5   7 , Paulo Sergio Sucasas da Costa  8 , Marcos Pereira de Ávila  7   9 , Marcello Braga Viggiano  10 , Waldemar Naves do Amaral  11 , Valeria Christina de Rezende Feres  12 , Fabiola Souza Fiaccadori  13 , Ana Laura de Sene Amancio Zara  14 , Angela Ferreira-Lopes  12 , Marilia Dalva Turchi  15
Affiliations

Risk of adverse pregnancy and infant outcomes associated with prenatal Zika virus infection: a post-epidemic cohort in Central-West Brazil

Luiza Emylce Pela Rosado et al. Sci Rep. .

Abstract

This study aimed to estimate the risks of adverse infant outcomes in the first year of life related to prenatal Zika virus (ZIKV) exposure. A prospective cohort of pregnant women with rash was recruited in Central-West Brazil in a post-epidemic period (January 2017 to April 2019). We evaluated participants' medical histories and performed ZIKV diagnostic testing using molecular (reverse transcription polymerase chain reaction [RT-PCR]) and serologic (immunoglobulin [Ig]M and plaque reduction neutralization tests [PRNT90]) assays. The ZIKV-positive group included both RT-PCR-confirmed cases as well as IgM and/or PRNT90-positive probable cases. Children were evaluated at birth and in the first 12 months of life. Transfontanellar ultrasound, central nervous system computed tomography, eye fundoscopy and retinography were performed. We estimated the absolute risk and 95% confidence interval (95% CI) of adverse infant outcomes among confirmed prenatally ZIKV-exposed children. Among 81 pregnant women with rash, 43 (53.1%) were ZIKV infected. The absolute risk of microcephaly among offspring of ZIKV-infected pregnant women was 7.0% (95% CI: 1.5-19.1), including the two cases of microcephaly detected prenatally and one detected postnatally. In total, 54.5% (95% CI: 39.8-68.7) of children in the ZIKV-exposed group had at least one ophthalmic abnormality, with the most frequent abnormalities being focal pigmentary mottling and chorioretinal atrophy or scarring. Our findings reinforce the importance of long-term monitoring of prenatally ZIKV-exposed children born apparently asymptomatic for Congenital Zika Syndrome.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of the recruitment and diagnosis of pregnant women with rash and suspected ZIKV infection from the cohort of Goiânia, Goiás, Brazil, 2017–2019.
Figure 2
Figure 2
Color retinography of a preterm infant exposed to ZIKV with focal pigmentary mottling (blue arrow) with chorioretinal scarring (white arrow).
Figure 3
Figure 3
Monochrome retinography of the same case showing retinopathy of prematurity without retinal hemorrhage. The white arrows show the typical tortuous vessels of retinopathy of prematurity.
See this image and copyright information in PMC

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