Early maternal Zika infection predicts severe neonatal neurological damage: results from the prospective Natural History of Zika Virus Infection in Gestation cohort study
Early maternal Zika infection predicts severe neonatal neurological damage: results from the prospective Natural History of Zika Virus Infection in Gestation cohort study
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DOI：
10.1111/1471-0528.16490
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发表时间：
2020-10-08
影响因子：
5.8
通讯作者：
Mussi-Pinhata, M. M.
中科院分区：
文献类型：
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作者：
Coutinho, C. M.;Negrini, S. F. B. M.;Mussi-Pinhata, M. M.
目的确定ZIKV感染的巴西妇女及其婴儿的大型队列中母亲感染不良结局的患病率。设计前瞻性人群队列研究。设置里贝劳普雷托地区的私人和公共卫生设施。人口有症状的ZIKV感染母亲及其婴儿。方法收集所有母婴对的产前/早期新生儿资料。一组婴儿在3个月内进行了头颅超声检查、眼底镜检查、听力和神经系统检查以及Bayley III筛查试验。主要结果测量根据感染的胎龄，在出生时或在3个月内检测到的妊娠丢失和异常的患病率。总体而言，从总共1116名有症状的妇女中确定了511名ZIKV感染妇女;由于有两个双胞胎，总共包括513个胎儿。其中，13例（2.5%; 95% CI 1.5-4.3）出现先天性寨卡综合征（CZS）的主要体征。在511名妇女中，有489名活产和24名（4.7%）流产（20名流产和4名死胎）。ZIKV相关的异常发生在42/511（8.2%）母亲的后代中。在1/4（25.0%）死产婴儿和19/489（3.9%; 95% CI 2.5-5.9）活产婴儿中诊断出小头畸形或其他CNS畸形。妊娠期感染发生的胎儿异常的可能性为14.0倍（95%CI 7.6-26.0），
Objective To define the prevalence of adverse outcomes of maternal infection in a large cohort of ZIKV-infected Brazilian women and their infants. Design Prospective population-based cohort study. Setting Ribeirao Preto's region's private and public health facilities. Population Symptomatic ZIKV-infected mothers and their infants. Methods Prenatal/early neonatal data were obtained for all mother-child pairs. A subgroup of infants had cranial ultrasonography, eye fundoscopy, hearing and neurological examinations and Bayley III screening tests within 3 months of age. Main outcome measures Prevalence of pregnancy losses and anomalies detected at birth or within 3 months according to the gestational age of infection. Results Overall, 511 ZIKV-infected women were identified from a total of 1116 symptomatic women; as there were two twins, there were a total of 513 fetuses included. Of these, 13 (2.5%; 95% CI 1.5-4.3) presented with major signs of congenital Zika syndrome (CZS). Of the 511 women, there were 489 livebirths and 24 (4.7%) pregnancy losses (20 miscarriages and four stillbirths). ZIKV-related anomalies occurred in the offspring of 42/511 (8.2%) mothers. Microcephaly or other CNS malformations were diagnosed in 1/4 (25.0%) stillbirths and in 19/489 (3.9%; 95% CI 2.5-5.9) of the liveborn infants. Fetal abnormalities were 14.0 (95% CI 7.6-26.0) times more likely with gestational infection occurring in