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Vital Signs: Update on Zika Virus–Associated Birth Defects and Evaluation of All U.S. Infants with Congenital Zika Virus Exposure — U.S. Zika Pregnancy Registry, 2016

2017; Centers for Disease Control and Prevention; Volume: 66; Issue: 13 Linguagem: Inglês

10.15585/mmwr.mm6613e1

1545-861X

Megan R. Reynolds, Abbey M. Jones, Emily E. Petersen, Ellen H. Lee, Marion E. Rice, Andrea Bingham, Sascha Ellington, Nicole Evert, Sarah Reagan-Steiner, Titilope Oduyebo, Catherine Brown, Stacey W. Martin, Nina Ahmad, Julu Bhatnagar, Jennifer Macdonald, Carolyn Gould, Anne D. Fine, Kara D. Polen, Heather Lake‐Burger, Christina Hillard, Noémi B. Hall, Mahsa M. Yazdy, Karnesha Slaughter, Jamie N. Sommer, Alys Adamski, Meghan Raycraft, Shannon Fleck‐Derderian, Jyoti Gupta, Kimberly Newsome, Madelyn A. Baez-Santiago, Sally Slavinski, Jennifer White, Cynthia A. Moore, Carrie K. Shapiro‐Mendoza, Lyle R. Petersen, Coleen Boyle, Denise J. Jamieson, Dana Meaney‐Delman, Margaret A. Honein, Jennifer Keys Adair, Irene Ruberto, Dirk Haselow, Lucille K. Im, Wendy Jilek, Monica S. Lehmann, Richard S. Olney, Charsey Cole Porse, Karen C. Ramstrom, Similoluwa Sowunmi, Natalie S. Marzec, K. Justin Davis, Andrea Morrison, M. Zachariah Fraser, Colleen Ann O'Connor, Wendy Chung, Folasuyi Richardson, Taylor Sexton, Meredith E. Stocks, Senait Woldai, Amanda Marie Bundek, Jennifer L. Zambri, Cynthia C. Goldberg, Leah Eisenstein, Jennifer Jackson, Russell Kopit, Teresa C. Logue, Raphael Mendoza, Amanda Feldpausch, Teri Graham, Sylvia Mann, Sarah Y. Park, Kris K. Carter, Emily Potts, Taryn Stevens, Sean Simonson, Julius Tonzel, Shari Davis, Sara Robinson, Judie Hyun, Erin Jenkins, Monika Piccardi, Lawrence D. Reid, Julie E. Dunn, Cathleen A. Higgins, Angela E. Lin, Gerlinde S. Munshi, Kayleigh Sandhu, Sarah Scotland, Susan Soliva, Glenn Copeland, Kimberly Signs, Elizabeth Schiffman, Paul Byers, Sheryl Hand, Christine L. Mulgrew, Jeff Hamik, Samir Koirala, Lisa Ludwig, Carolyn Fredette, Kristin Garafalo, K. J. Worthington, Abubakar Ropri, Julius N. Ade, Zahra S. Alaali, Debra Blog, Scott Brunt, Patrick Bryant, Amy E. Burns, Steven Bush, Kyle Carson, Amy B. Dean, Valerie L. Demarest, Elizabeth Dufort, Alan P. Dupuis, Ann Sullivan-Frohm, Andrea Marias Furuya, Meghan Fuschino, Viola H. Glaze, J. P. Griffin, Christina Hidalgo, Karen E. Kulas, Daryl M. Lamson, Lou Ann Lance, William T. Lee, Ronald J. Limberger, Patricia S. Many, Mary J. Marchewka, Brenda Elizabeth Naizby, MaryJo Polfleit, Michael Popowich, Tabassum Rahman, Timothy Rem, Amy E. Robbins, Jemma V. Rowlands, Chantelle Seaver, Kimberley A. Seward, Lou C. Smith, Inderbir Sohi, Kirsten St. George, Maria I. Souto, Rachel Wester, Susan J. Wong, Li Zeng, Joel Ackelsberg, Byron Alex, Vennus Ballen, Jennifer Baumgartner, Danielle Bloch, Sandhya Clark, Erin E. Conners, Hannah Cooper, Alexander Davidson, Catherine Dentinger, Bisram Deocharan, Andrea K. DeVito, Jie Fu, Gili Hrusa, Maryam Iqbal, Martha Iwamoto, Lucretia Jones, Hannah Kubinson, Maura K. Lash, Marcelle Layton, Christopher T. Lee, Dakai Liu, Emily McGibbon, Morgan Moy, Stephanie Ngai, Hilary Parton, Eric Peterson, Jose Poy, Jennifer L. Rakeman, Alaina Stoute, Corinne N. Thompson, Don Weiss, Emily Westheimer, Ann Winters, Mohammad Younis, Ronna L. Chan, Laura Cronquist, Lisa Caton, Leah Lind, Kumar Nalluswami, Dana Perella, Diane Brady, Michael Gosciminski, Patricia McAuley, Daniel Drociuk, Vinita Leedom, Brian Witrick, Jan Bollock, Marie Bottomley Hartel, Loraine Swanson Lucinski, Morgan McDonald, Angela M. Miller, Tori Armand Ponson, Laura Price, Amy Nance, Dallin Peterson, Sally Cook, Brennan Martin, Hanna N. Oltean, Jillian Neary, Melissa A. Baker, Kathy Cummons, Katie Bryan, Kathryn E. Arnold, Annelise C. Arth, Brigid C. Bollweg, Janet D. Cragan, April L. Dawson, Amy M. Denison, Eric J. Dziuban, Lindsey Estetter, Luciana Silva‐Flannery, Rebecca J. Free, Romeo R. Galang, Joy Gary, Cynthia S. Goldsmith, Caitlin Green, Gillian Hale, Heather M. Hayes, Irogue Igbinosa, M. Kelly Keating, Sumaiya Khan, Shin Y. Kim, Margaret A. Lampe, Amanda Lewis, Cara Mai, Roosecelis B. Martines, Brooke Miers, Jazmyn Moore, Atis Muehlenbachs, John F. Nahabedian, Amanda J. Panella, Vaunita Parihar, Mitesh Patel, D. Brett Rabeneck, Sonja A. Rasmussen, Jana Ritter, Dominique Rollin, Jeanine H. Sanders, Wun‐Ju Shieh, Regina M. Simeone, Elizabeth L. Simon, John R. Sims, Pamela Spivey, Helen Talley-McRae, Alphonse K. Tshiwala, Kelley VanMaldeghem, Laura Viens, Anne Wainscott-Sargent, Tonya Williams, Sherif R. Zaki,

Global Maternal and Child Health

In collaboration with state, tribal, local, and territorial health departments, CDC established the U.S. Zika Pregnancy Registry (USZPR) in early 2016 to monitor pregnant women with laboratory evidence of possible recent Zika virus infection and their infants.This report includes an analysis of completed pregnancies (which include live births and pregnancy losses, regardless of gestational age) in the 50 U.S. states and the District of Columbia (DC) with laboratory evidence of possible recent Zika virus infection reported to the USZPR from January 15 to December 27, 2016. Birth defects potentially associated with Zika virus infection during pregnancy include brain abnormalities and/or microcephaly, eye abnormalities, other consequences of central nervous system dysfunction, and neural tube defects and other early brain malformations.During the analysis period, 1,297 pregnant women in 44 states were reported to the USZPR. Zika virus-associated birth defects were reported for 51 (5%) of the 972 fetuses/infants from completed pregnancies with laboratory evidence of possible recent Zika virus infection (95% confidence interval [CI] = 4%-7%); the proportion was higher when restricted to pregnancies with laboratory-confirmed Zika virus infection (24/250 completed pregnancies [10%, 95% CI = 7%-14%]). Birth defects were reported in 15% (95% CI = 8%-26%) of fetuses/infants of completed pregnancies with confirmed Zika virus infection in the first trimester. Among 895 liveborn infants from pregnancies with possible recent Zika virus infection, postnatal neuroimaging was reported for 221 (25%), and Zika virus testing of at least one infant specimen was reported for 585 (65%).These findings highlight why pregnant women should avoid Zika virus exposure. Because the full clinical spectrum of congenital Zika virus infection is not yet known, all infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy should receive postnatal neuroimaging and Zika virus testing in addition to a comprehensive newborn physical exam and hearing screen. Identification and follow-up care of infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy and infants with possible congenital Zika virus infection can ensure that appropriate clinical services are available.