sharon sanders
Editor-in-Chief & President
Zika Virus Infection in Pregnant Women in Rio de Janeiro
Patr?cia Brasil, M.D., Ph.D., Jos? P. Pereira, Jr., M.D., M. Elisabeth Moreira, M.D., Ph.D., Rita M. Ribeiro Nogueira, M.D., Ph.D., Luana Damasceno, Pharm.D., Mayumi Wakimoto, M.D., Ph.D., Renata S. Rabello, D.V.M., Ph.D., Stephanie G. Valderramos, M.D., Ph.D., Umme-Aiman Halai, M.D., Tania S. Salles, M.D., Ph.D., Andrea A. Zin, M.D., Ph.D., Dafne Horovitz, M.D., Ph.D., Pedro Daltro, M.D., Ph.D., Marcia Boechat, M.D., Ph.D., Claudia Raja Gabaglia, M.D., Ph.D., Patr?cia Carvalho de Sequeira, Ph.D., Jos? H. Pilotto, M.D., Ph.D., Raquel Medialdea-Carrera, Ph.D., Denise Cotrim da Cunha, M.D., Liege M. Abreu de Carvalho, M.D., Marcos Pone, M.D., Andr? Machado Siqueira, M.D., Ph.D., Guilherme A. Calvet, M.D., Ph.D., Ana E. Rodrigues Bai?o, M.D., Elizabeth S. Neves, M.D., Ph.D., Paulo R. Nassar de Carvalho, M.D., Renata H. Hasue, Ph.D., Peter B. Marschik, Ph.D., Christa Einspieler, Ph.D., Carla Janzen, M.D., Ph.D., James D. Cherry, M.D., Ana M. Bispo de Filippis, Ph.D., and Karin Nielsen-Saines, M.D.
December 13, 2016DOI: 10.1056/NEJMoa1602412
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RESULTS
A total of 345 women were enrolled from September 2015 through May 2016; of these, 182 women (53%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 6 to 39 weeks of gestation. Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). By July 2016, a total of 134 ZIKV-affected pregnancies and 73 ZIKV-unaffected pregnancies had reached completion, with outcomes known for 125 ZIKV-affected and 61 ZIKV-unaffected pregnancies. Infection with chikungunya virus was identified in 42% of women without ZIKV infection versus 3% of women with ZIKV infection (P<0.001). Rates of fetal death were 7% in both groups; overall adverse outcomes were 46% among offspring of ZIKV-positive women versus 11.5% among offspring of ZIKV-negative women (P<0.001).
Among 117 live infants born to 116 ZIKV-positive women, 42% were found to have grossly abnormal clinical or brain imaging findings or both, including 4 infants with microcephaly.
Adverse outcomes were noted regardless of the trimester during which the women were infected with ZIKV (55% of pregnancies had adverse outcomes after maternal infection in the first trimester, 52% after infection in the second trimester, and 29% after infection in the third trimester).
http://www.nejm.org/doi/full/10.1056...=featured_home
Patr?cia Brasil, M.D., Ph.D., Jos? P. Pereira, Jr., M.D., M. Elisabeth Moreira, M.D., Ph.D., Rita M. Ribeiro Nogueira, M.D., Ph.D., Luana Damasceno, Pharm.D., Mayumi Wakimoto, M.D., Ph.D., Renata S. Rabello, D.V.M., Ph.D., Stephanie G. Valderramos, M.D., Ph.D., Umme-Aiman Halai, M.D., Tania S. Salles, M.D., Ph.D., Andrea A. Zin, M.D., Ph.D., Dafne Horovitz, M.D., Ph.D., Pedro Daltro, M.D., Ph.D., Marcia Boechat, M.D., Ph.D., Claudia Raja Gabaglia, M.D., Ph.D., Patr?cia Carvalho de Sequeira, Ph.D., Jos? H. Pilotto, M.D., Ph.D., Raquel Medialdea-Carrera, Ph.D., Denise Cotrim da Cunha, M.D., Liege M. Abreu de Carvalho, M.D., Marcos Pone, M.D., Andr? Machado Siqueira, M.D., Ph.D., Guilherme A. Calvet, M.D., Ph.D., Ana E. Rodrigues Bai?o, M.D., Elizabeth S. Neves, M.D., Ph.D., Paulo R. Nassar de Carvalho, M.D., Renata H. Hasue, Ph.D., Peter B. Marschik, Ph.D., Christa Einspieler, Ph.D., Carla Janzen, M.D., Ph.D., James D. Cherry, M.D., Ana M. Bispo de Filippis, Ph.D., and Karin Nielsen-Saines, M.D.
December 13, 2016DOI: 10.1056/NEJMoa1602412
snip
RESULTS
A total of 345 women were enrolled from September 2015 through May 2016; of these, 182 women (53%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 6 to 39 weeks of gestation. Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). By July 2016, a total of 134 ZIKV-affected pregnancies and 73 ZIKV-unaffected pregnancies had reached completion, with outcomes known for 125 ZIKV-affected and 61 ZIKV-unaffected pregnancies. Infection with chikungunya virus was identified in 42% of women without ZIKV infection versus 3% of women with ZIKV infection (P<0.001). Rates of fetal death were 7% in both groups; overall adverse outcomes were 46% among offspring of ZIKV-positive women versus 11.5% among offspring of ZIKV-negative women (P<0.001).
Among 117 live infants born to 116 ZIKV-positive women, 42% were found to have grossly abnormal clinical or brain imaging findings or both, including 4 infants with microcephaly.
Adverse outcomes were noted regardless of the trimester during which the women were infected with ZIKV (55% of pregnancies had adverse outcomes after maternal infection in the first trimester, 52% after infection in the second trimester, and 29% after infection in the third trimester).
http://www.nejm.org/doi/full/10.1056...=featured_home
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