Reassessment of the Risk of Birth Defects Due to Zika Virus in Guadeloupe, 2016

Overview

Journal PLoS Negl Trop Dis

Specialties Infectious Diseases
Tropical Medicine

Date 2021 Mar 3

PMID 33657112

Citations 4

Authors

Anna L Funk

Bruno Hoen

Ingrid Vingdassalom

Catherine Ryan

Philippe Kadhel

Kinda Schepers

Stanie Gaete

Benoit Tressieres

Arnaud Fontanet

Affiliations

Soon will be listed here.

Abstract

Background: In the French Territories in the Americas (FTA), the risk of birth defects possibly associated with Zika virus (ZIKV) infection was 7.0% (95%CI: 5.0 to 9.5) among foetuses/infants of 546 women with symptomatic RT-PCR confirmed ZIKV infection during pregnancy. Many of these defects were isolated measurement-based microcephaly (i.e. without any detected brain or clinical abnormalities) or mild neurological conditions. We wanted to estimate the proportion of such minor findings among live births of women who were pregnant in the same region during the outbreak period but who were not infected with ZIKV.

Methods: In Guadeloupe, pregnant women were recruited at the time of delivery and tested for ZIKV infection. The outcomes of live born infants of ZIKV non-infected women were compared to those of ZIKV-exposed live born infants in Guadeloupe, extracted from the FTA prospective cohort.

Results: Of 490 live born infants without exposure to ZIKV, 42 infants (8.6%, 95%CI: 6.2-11.4) had mild abnormalities that have been described as 'potentially linked to ZIKV infection'; all but one of these was isolated measurement-based microcephaly. Among the 241 live born infants with ZIKV exposure, the proportion of such abnormalities, using the same definition, was similar (6.6%, 95%CI: 3.8-10.6).

Conclusions: Isolated anthropometric abnormalities and mild neurological conditions were as prevalent among infants with and without in-utero ZIKV exposure. If such abnormalities had not been considered as 'potentially linked to ZIKV' in the original prospective cohort in Guadeloupe, the overall estimate of the risk of birth defects considered due to the virus would have been significantly lower, at approximately 1.6% (95% CI: 0.4-4.1).

Trial Registration: ClinicalTrials.gov (NCT02916732).

Citing Articles

[Zika virus infection: sexual transmission and implications for prevention].

Consigny P Med Trop Sante Int. 2024; 4(2).

PMID: 39099710 PMC: 11292433. DOI: 10.48327/mtsi.v4i2.2024.502.

Arboviral Risk Associated with Solid Organ and Hematopoietic Stem Cell Grafts: The Prophylactic Answers Proposed by the French High Council of Public Health in a National Context.

Pozzetto B, Grard G, Durand G, Paty M, Gallian P, Lucas-Samuel S Viruses. 2023; 15(9).

PMID: 37766192 PMC: 10536626. DOI: 10.3390/v15091783.

Consequences of In Utero Zika Virus Exposure and Adverse Pregnancy and Early Childhood Outcomes: A Prospective Cohort Study.

Grant R, Flechelles O, Elenga N, Tressieres B, Gaete S, Hebert J Viruses. 2022; 14(12).

PMID: 36560760 PMC: 9788325. DOI: 10.3390/v14122755.

Transplacental Zika virus transmission in ex vivo perfused human placentas.

Langerak T, Broekhuizen M, Unger P, Tan L, Koopmans M, van Gorp E PLoS Negl Trop Dis. 2022; 16(4):e0010359.

PMID: 35442976 PMC: 9060339. DOI: 10.1371/journal.pntd.0010359.

References

Dommergues M, Mandelbrot L, Mahieu-Caputo D, Boudjema N, Durand-Zaleski I . Termination of pregnancy following prenatal diagnosis in France: how severe are the foetal anomalies?. Prenat Diagn. 2010; 30(6):531-9. DOI: 10.1002/pd.2510. View

Souza W, de Albuquerque M, Vazquez E, Bezerra L, Mendes A, Lyra T . Microcephaly epidemic related to the Zika virus and living conditions in Recife, Northeast Brazil. BMC Public Health. 2018; 18(1):130. PMC: 5767029. DOI: 10.1186/s12889-018-5039-z. View

Liu S, Metcalfe A, Leon J, Sauve R, Kramer M, Joseph K . Evaluation of the INTERGROWTH-21st project newborn standard for use in Canada. PLoS One. 2017; 12(3):e0172910. PMC: 5336248. DOI: 10.1371/journal.pone.0172910. View

Silva A, Barbieri M, Alves M, Carvalho C, Batista R, Ribeiro M . Prevalence and Risk Factors for Microcephaly at Birth in Brazil in 2010. Pediatrics. 2018; 141(2). DOI: 10.1542/peds.2017-0589. View

Hoen B, Schaub B, Funk A, Ardillon V, Boullard M, Cabie A . Pregnancy Outcomes after ZIKV Infection in French Territories in the Americas. N Engl J Med. 2018; 378(11):985-994. DOI: 10.1056/NEJMoa1709481. View

Oliveira-Filho J, Felzemburgh R, Costa F, Nery N, Mattos A, Henriques D . Seizures as a Complication of Congenital Zika Syndrome in Early Infancy. Am J Trop Med Hyg. 2018; 98(6):1860-1862. PMC: 6086187. DOI: 10.4269/ajtmh.17-1020. View

Araujo T, Ximenes R, Miranda-Filho D, Souza W, Montarroyos U, de Melo A . Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study. Lancet Infect Dis. 2017; 18(3):328-336. PMC: 7617036. DOI: 10.1016/S1473-3099(17)30727-2. View

Wheeler A . Development of Infants With Congenital Zika Syndrome: What Do We Know and What Can We Expect?. Pediatrics. 2018; 141(Suppl 2):S154-S160. PMC: 5795516. DOI: 10.1542/peds.2017-2038D. View

Pomar L, Vouga M, Lambert V, Pomar C, Hcini N, Jolivet A . Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana. BMJ. 2018; 363:k4431. PMC: 6207920. DOI: 10.1136/bmj.k4431. View

10.

Garne E, Khoshnood B, Loane M, Boyd P, Dolk H . Termination of pregnancy for fetal anomaly after 23 weeks of gestation: a European register-based study. BJOG. 2010; 117(6):660-6. DOI: 10.1111/j.1471-0528.2010.02531.x. View

11.

Campos M, Dombrowski J, Phelan J, Marinho C, Hibberd M, Clark T . Zika might not be acting alone: Using an ecological study approach to investigate potential co-acting risk factors for an unusual pattern of microcephaly in Brazil. PLoS One. 2018; 13(8):e0201452. PMC: 6093667. DOI: 10.1371/journal.pone.0201452. View

12.

Berard A, Abbas-Chorfa F, Kassai B, Vial T, Nguyen K, Sheehy O . The French Pregnancy Cohort: Medication use during pregnancy in the French population. PLoS One. 2019; 14(7):e0219095. PMC: 6636733. DOI: 10.1371/journal.pone.0219095. View

13.

Pasquier C, Joguet G, Mengelle C, Chapuy-Regaud S, Pavili L, Prisant N . Kinetics of anti-ZIKV antibodies after Zika infection using two commercial enzyme-linked immunoassays. Diagn Microbiol Infect Dis. 2017; 90(1):26-30. DOI: 10.1016/j.diagmicrobio.2017.09.001. View

14.

Pomar L, Malinger G, Benoist G, Carles G, Ville Y, Rousset D . Association between Zika virus and fetopathy: a prospective cohort study in French Guiana. Ultrasound Obstet Gynecol. 2017; 49(6):729-736. DOI: 10.1002/uog.17404. View

15.

Matheus S, Talla C, Labeau B, de Laval F, Briolant S, Berthelot L . Performance of 2 Commercial Serologic Tests for Diagnosing Zika Virus Infection. Emerg Infect Dis. 2019; 25(6):1153-1160. PMC: 6537740. DOI: 10.3201/eid2506.180361. View

16.

Calvet G, Aguiar R, Melo A, Sampaio S, de Filippis I, Fabri A . Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study. Lancet Infect Dis. 2016; 16(6):653-660. DOI: 10.1016/S1473-3099(16)00095-5. View

17.

Albert P, Grantz K . Fetal growth and ethnic variation. Lancet Diabetes Endocrinol. 2014; 2(10):773. PMC: 10428134. DOI: 10.1016/S2213-8587(14)70186-X. View

18.

de Oliveira Dias J, Ventura C, Freitas B, Prazeres J, Ventura L, Bravo-Filho V . Zika and the Eye: Pieces of a Puzzle. Prog Retin Eye Res. 2018; 66:85-106. DOI: 10.1016/j.preteyeres.2018.04.004. View

19.

Morris J, Rankin J, Garne E, Loane M, Greenlees R, Addor M . Prevalence of microcephaly in Europe: population based study. BMJ. 2016; 354:i4721. PMC: 5021822. DOI: 10.1136/bmj.i4721. View

20.

Krow-Lucal E, de Andrade M, Cananea J, Moore C, Leite P, Biggerstaff B . Association and birth prevalence of microcephaly attributable to Zika virus infection among infants in Paraíba, Brazil, in 2015-16: a case-control study. Lancet Child Adolesc Health. 2018; 2(3):205-213. DOI: 10.1016/S2352-4642(18)30020-8. View