Anna L Funk1,2, Bruno Hoen3, Ingrid Vingdassalom3, Catherine Ryan4, Philippe Kadhel5,6, Kinda Schepers7, Stanie Gaete8, Benoit Tressières3, Arnaud Fontanet1,9. 1. Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France. 2. Sorbonne Université, Paris, France. 3. INSERM Centre d'Investigation Clinique 1424, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France. 4. Centre Pluridisciplinaire de Diagnostic Prénatal, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France. 5. Université des Antilles, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France. 6. Institut de Recherche en Santé, Environnement et Travail (IRSET), Université de Rennes, Rennes, France. 7. Infectious Diseases Department, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France. 8. Centre de Ressources Biologiques Karubiotec, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France. 9. Unité Pasteur-CNAM Risques Infectieux et Émergents, Conservatoire National des Arts et Métiers, Paris, France.
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).
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 ZIKVinfection 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 ZIKVinfection. The outcomes of live born infants of ZIKV non-infectedwomen 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 ZIKVinfection'; 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).
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