PDF(Pubmed)
Abstract：
We aimed to describe adverse pregnancy outcomes among women who had symptomatic, RT-PCR-confirmed ZIKV infection and early childhood outcomes among their infants. We enrolled pregnant women with symptomatic, RT-PCR-confirmed ZIKV infection in a prospective cohort study, and their infants in a prospective pediatric cohort study. We defined adverse pregnancy and early childhood outcomes based on selected neurologic, ophthalmologic, auditory, musculoskeletal, and anthropometric abnormalities. We used RT-PCR and serologic tests to determine the ZIKV infection status of the child. Between 10 March and 24 November 2016, we enrolled 546 pregnant women with RT-PCR-confirmed ZIKV infection. The overall risk of adverse pregnancy and early childhood outcomes possibly related to in utero ZIKV exposure was 15.7% (95% CI: 12.8-19.0), distributed as follows: 3.6% (95% CI: 2.3-5.6) severe sequelae or fatality; 2.7% (95% CI: 1.6-4.5) major abnormalities; 9.4% (95% CI:7.1-12.2) mild abnormalities. The risk of severe sequelae or fatality was higher when ZIKV infection occurred during the first trimester (7.0%), compared to the second (2.7%) or third trimester (1.4%) (p = 0.02). Among the infants for whom ZIKV infection status could be determined, the vertical transmission rate was 3.0% (5/167) (95% CI: 1.1-7.2). Among pregnant women with symptomatic, RT-PCR-confirmed ZIKV infection, severe or major pregnancy or early childhood outcomes were present in 6.3% of fetuses and infants. Severe outcomes occurred more frequently in fetuses and infants whose mothers had been infected in the first trimester.
摘要：
我们旨在描述有症状的女性的不良妊娠结局，RT-PCR证实其婴儿的ZIKV感染和早期儿童结局。我们招募了有症状的孕妇，在一项前瞻性队列研究中，RT-PCR证实的ZIKV感染，和他们的婴儿在一项前瞻性儿科队列研究中。我们根据选定的神经系统定义不良妊娠和早期儿童结局，眼科,听觉,肌肉骨骼，和人体测量异常.我们使用RT-PCR和血清学测试来确定儿童的ZIKV感染状况。2016年3月10日至11月24日，我们招募了546例RT-PCR证实的ZIKV感染孕妇。可能与子宫内ZIKV暴露有关的不良妊娠和早期儿童结局的总体风险为15.7％（95％CI：12.8-19.0），分布如下：3.6％（95％CI：2.3-5.6）严重后遗症或死亡；2.7％（95％CI：1.6-4.5）主要异常；9.4％（95％CI：7.1-12.2）轻度异常。在妊娠早期发生ZIKV感染时，严重后遗症或死亡的风险更高（7.0％），与妊娠中期（2.7％）或妊娠中期（1.4％）相比（p=0.02）。在可以确定ZIKV感染状态的婴儿中，垂直传播率为3.0%(5/167)(95%CI:1.1-7.2)。在有症状的孕妇中，RT-PCR证实ZIKV感染，6.3%的胎儿和婴儿出现严重或严重妊娠或儿童早期结局.在母亲在妊娠早期感染的胎儿和婴儿中，严重的结局更常见。
