| Author | Pereira, Jose Paulo | |
| Author | Nielsen-Saines, Karin | |
| Author | Sperling, Jeffrey | |
| Author | Maykin, Melanie M. | |
| Author | Damasceno, Luana | |
| Author | Cardozo, Renan Fonseca | |
| Author | Valle, Helena Abreu | |
| Author | Dutra, Beatriz Ribeiro Torres | |
| Author | Gama, Helder Dotta | |
| Author | Adachi, Kristina | |
| Author | Zin, Andrea A. | |
| Author | Tsui, Irena | |
| Author | Vasconcelos, Zilton Farias Meira de | |
| Author | Brasil, Patricia | |
| Author | Moreira, Maria E. | |
| Author | Gaw, Stephanie L. | |
| Access date | 2019-05-07T12:49:01Z | |
| Available date | 2019-05-07T12:49:01Z | |
| Document date | 2018 | |
| Citation | PEREIRA, Jose Paulo et al. Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil. Jama Network Open, v. 1, n. 8, p. 1-12, Dec. 28 2018. | pt_BR |
| ISSN | 2574-3805 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/32971 | |
| Language | eng | pt_BR |
| Publisher | American Medical Association | pt_BR |
| Rights | open access | |
| Title | Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1001/jamanetworkopen.2018.6529 | |
| Abstract | IMPORTANCE: Congenital Zika virus infection causes a spectrum of adverse birth outcomes, including severe birth defects of the central nervous system. The association of prenatal ultrasonographic findings with adverse neonatal outcomes, beyond structural anomalies such as microcephaly, has not been described to date.
OBJECTIVE: To determine whether prenatal ultrasonographic examination results are associated with abnormal neonatal outcomes in Zika virus–affected pregnancies. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study conducted at a single regional referral center in Rio de Janeiro, Brazil, from September 1, 2015, to May 31, 2016, among 92 pregnant women diagnosed during pregnancy with Zika virus infection by reverse-transcription polymerase chain reaction, who underwent subsequent prenatal ultrasonographic and neonatal evaluation. EXPOSURES: Prenatal ultrasonography. MAIN OUTCOMES AND MEASURES: The primary outcome measure was composite adverse neonatal outcome (perinatal death, abnormal finding on neonatal examination, or abnormal finding on postnatal neuroimaging). Secondary outcomes include association of specific findings with neonatal outcomes. RESULTS: Of 92 mother-neonate dyads (mean [SD] maternal age, 29.4 [6.3] years), 55 (60%) had normal results and 37 (40%) had abnormal results on prenatal ultrasonographic examinations. The median gestational age at delivery was 38.6 weeks (interquartile range, 37.9-39.3). Of the 45 neonates with composite adverse outcome, 23 (51%) had normal results on prenatal ultrasonography. Eleven pregnant women (12%) had a Zika virus–associated finding that was associated with an abnormal result on neonatal examination (adjusted odds ratio [aOR], 11.6; 95% CI,
1.8-72.8), abnormal result on postnatal neuroimaging (aOR, 6.7; 95% CI, 1.1-38.9), and composite adverse neonatal outcome (aOR, 27.2; 95% CI, 2.5-296.6). Abnormal results on middle cerebral artery Doppler ultrasonography were associated with neonatal examination abnormalities (aOR, 12.8; 95% CI, 2.6-63.2), postnatal neuroimaging abnormalities (aOR, 8.8; 95% CI, 1.7-45.9), and composite adverse neonatal outcome (aOR, 20.5; 95% CI, 3.2-132.6). There were 2 perinatal deaths. Abnormal findings on prenatal ultrasonography had a sensitivity of 48.9% (95% CI, 33.7%-64.2%) and a specificity of 68.1% (95% CI, 52.9%-80.1%) for association with composite adverse neonatal outcomes. For a Zika virus–associated abnormal result on prenatal ultrasonography, the sensitivity was lower (22.2%; 95% CI, 11.2%-37.1%) but the specificity was higher (97.9%; 95% CI, 88.7%-99.9%). CONCLUSIONS AND RELEVANCE: Abnormal results on prenatal ultrasonography were associated with adverse outcomes in congenital Zika infection. The absence of abnormal findings on prenatal ultrasonography was not associated with a normal neonatal outcome. Comprehensive evaluation is recommended for all neonates with prenatal Zika virus exposure. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of California. Department of Pediatrics. Division of Pediatric Infectious Diseases. Los Angeles, CA, USA. | pt_BR |
| Affilliation | University of California. Department of Obstetrics, Gynecology, and Reproductive Sciences. Division of Maternal-Fetal Medicine. San Francisco, CA, USA. | pt_BR |
| Affilliation | University of California. Department of Obstetrics, Gynecology, and Reproductive Sciences. Division of Maternal-Fetal Medicine. San Francisco, CA, USA. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of California. Department of Pediatrics. Division of Pediatric Infectious Diseases. Los Angeles, CA, USA. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of California. Jules Stein Eye Institute. Retina Division. Los Angeles, CA, USA. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of California. Department of Obstetrics, Gynecology, and Reproductive Sciences. Division of Maternal-Fetal Medicine. San Francisco, CA, USA. | pt_BR |
| Subject | Zika virus infection | pt_BR |
| Subject | Prenatal ultrasonographic | pt_BR |
| Subject | Adverse neonatal outcomes | pt_BR |
| Subject | Pregnant women | pt_BR |
| Subject | Brazil | pt_BR |
| Embargo date | 2020-05-07 | |
| xmlui.metadata.dc.subject.ods | 05 Igualdade de gênero | |
