Zika Virus Infection in Pregnancy, Microcephaly, and Maternal and Fetal Health
Zika Virus Infection in Pregnancy, Microcephaly, and Maternal and Fetal Health
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DOI：
10.5858/arpa.2016-0382-ra
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发表时间：
2017-01-01
影响因子：
4.6
通讯作者：
Schwartz, David A.
中科院分区：
文献类型：
--
作者：
Alvarado, Maria Gabriela;Schwartz, David A.
上下文。寨卡病毒（ZIKV）感染的全球流行已成为影响孕妇及其婴儿的重要公共卫生问题。目的：综述妊娠期寨卡病毒感染与宫内胎儿感染、小头畸形、脑损伤、先天性畸形综合征和胎儿感染实验实验室模型之间的因果关系。关于母婴传播和疾病的危险因素、病理生理学、流行病学和时机，仍存在许多问题。这些包括胎儿脑损伤和小头畸形的机制；协同变量，如病毒负荷、病毒血症持续时间和宿主遗传在垂直传播中的作用；以及先天性寨卡综合征的临床和病理谱。其他问题包括确定感染婴儿的潜在长期身体和神经行为结果，母体或胎儿宿主遗传是否影响临床结果，以及寨卡病毒感染是否会导致孕产妇发病。最后，寨卡病毒感染的实验实验室和动物模型是否有助于解决母胎病毒传播和先天性小头畸形的发展？本通讯提供了最新信息，并试图解决其中一些重要问题。数据源。-对已发表的科学文献进行全面审查。流行病学、临床医学、病理学和实验研究的最新进展在较短时间内提供了关于寨卡病毒垂直传播以及先天性小头畸形、脑损伤和先天性寨卡综合征机制的大量新信息。然而，为了更全面地了解这种新出现的病毒性疾病对母体和胎儿的影响，仍需开展大量工作。
Context.-The global epidemic of Zika virus (ZIKV) infection has emerged as an important public health problem affecting pregnant women and their infants.Objectives.-To review the causal association between ZIKV infection during pregnancy and intrauterine fetal infection, microcephaly, brain damage, congenital malformation syndrome, and experimental laboratory models of fetal infection. Many questions remain regarding the risk factors, pathophysiology, epidemiology, and timing of maternal-fetal transmission and disease. These include mechanisms of fetal brain damage and microcephaly; the role of covariables, such as viral burden, duration of viremia, and host genetics, on vertical transmission; and the clinical and pathologic spectrum of congenital Zika syndrome. Additional questions include defining the potential long-term physical and neurobehavioral outcomes for infected infants, whether maternal or fetal host genetics influence the clinical outcome, and whether ZIKV infection can cause maternal morbidity. Finally, are experimental laboratory and animal models of ZIKV infection helpful in addressing maternal-fetal viral transmission and the development of congenital microcephaly? This communication provides current information and attempts to address some of these important questions.Data Sources.-Comprehensive review of published scientific literature.Conclusions.-Recent advances in epidemiology, clinical medicine, pathology, and experimental studies have provided a great amount of new information regarding vertical ZIKV transmission and the mechanisms of congenital microcephaly, brain damage, and congenital Zika syndrome in a relatively short time. However, much work still needs to be performed to more completely understand the maternal and fetal aspects of this new and emerging viral disease.