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PMID- 27960197
OWN - NLM
STAT- Publisher
DA  - 20161213
LR  - 20161214
IS  - 1538-3598 (Electronic)
IS  - 0098-7484 (Linking)
DP  - 2016 Dec 15
TI  - Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible
      Zika Virus Infection During Pregnancy.
LID - 10.1001/jama.2016.19006 [doi]
AB  - Importance: Understanding the risk of birth defects associated with Zika virus
      infection during pregnancy may help guide communication, prevention, and planning
      efforts. In the absence of Zika virus, microcephaly occurs in approximately 7 per
      10000 live births. Objective: To estimate the preliminary proportion of fetuses
      or infants with birth defects after maternal Zika virus infection by trimester of
      infection and maternal symptoms. Design, Setting, and Participants: Completed
      pregnancies with maternal, fetal, or infant laboratory evidence of possible
      recent Zika virus infection and outcomes reported in the continental United
      States and Hawaii from January 15 to September 22, 2016, in the US Zika Pregnancy
      Registry, a collaboration between the CDC and state and local health departments.
      Exposures: Laboratory evidence of possible recent Zika virus infection in a
      maternal, placental, fetal, or infant sample. Main Outcomes and Measures: Birth
      defects potentially Zika associated: brain abnormalities with or without
      microcephaly, neural tube defects and other early brain malformations, eye
      abnormalities, and other central nervous system consequences. Results: Among 442 
      completed pregnancies in women (median age, 28 years; range, 15-50 years) with
      laboratory evidence of possible recent Zika virus infection, birth defects
      potentially related to Zika virus were identified in 26 (6%; 95% CI, 4%-8%)
      fetuses or infants. There were 21 infants with birth defects among 395 live
      births and 5 fetuses with birth defects among 47 pregnancy losses. Birth defects 
      were reported for 16 of 271 (6%; 95% CI, 4%-9%) pregnant asymptomatic women and
      10 of 167 (6%; 95% CI, 3%-11%) symptomatic pregnant women. Of the 26 affected
      fetuses or infants, 4 had microcephaly and no reported neuroimaging, 14 had
      microcephaly and brain abnormalities, and 4 had brain abnormalities without
      microcephaly; reported brain abnormalities included intracranial calcifications, 
      corpus callosum abnormalities, abnormal cortical formation, cerebral atrophy,
      ventriculomegaly, hydrocephaly, and cerebellar abnormalities. Infants with
      microcephaly (18/442) represent 4% of completed pregnancies. Birth defects were
      reported in 9 of 85 (11%; 95% CI, 6%-19%) completed pregnancies with maternal
      symptoms or exposure exclusively in the first trimester (or first trimester and
      periconceptional period), with no reports of birth defects among fetuses or
      infants with prenatal exposure to Zika virus infection only in the second or
      third trimesters. Conclusions and Relevance: Among pregnant women in the United
      States with completed pregnancies and laboratory evidence of possible recent Zika
      infection, 6% of fetuses or infants had evidence of Zika-associated birth
      defects, primarily brain abnormalities and microcephaly, whereas among women with
      first-trimester Zika infection, 11% of fetuses or infants had evidence of
      Zika-associated birth defects. These findings support the importance of screening
      pregnant women for Zika virus exposure.
FAU - Honein, Margaret A
AU  - Honein MA
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Dawson, April L
AU  - Dawson AL
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Petersen, Emily E
AU  - Petersen EE
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Jones, Abbey M
AU  - Jones AM
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Lee, Ellen H
AU  - Lee EH
AD  - New York City Department of Health and Mental Hygiene, Queens, New York.
FAU - Yazdy, Mahsa M
AU  - Yazdy MM
AD  - Massachusetts Department of Public Health, Boston.
FAU - Ahmad, Nina
AU  - Ahmad N
AD  - New York State Department of Health, Albany.
FAU - Macdonald, Jennifer
AU  - Macdonald J
AD  - Virginia Department of Health, Richmond.
FAU - Evert, Nicole
AU  - Evert N
AD  - Texas Department of State Health Services, Austin.
FAU - Bingham, Andrea
AU  - Bingham A
AD  - Florida Department of Health, Tallahassee.
FAU - Ellington, Sascha R
AU  - Ellington SR
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Shapiro-Mendoza, Carrie K
AU  - Shapiro-Mendoza CK
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Oduyebo, Titilope
AU  - Oduyebo T
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Fine, Anne D
AU  - Fine AD
AD  - New York City Department of Health and Mental Hygiene, Queens, New York.
FAU - Brown, Catherine M
AU  - Brown CM
AD  - Massachusetts Department of Public Health, Boston.
FAU - Sommer, Jamie N
AU  - Sommer JN
AD  - New York State Department of Health, Albany.
FAU - Gupta, Jyoti
AU  - Gupta J
AD  - Virginia Department of Health, Richmond.
FAU - Cavicchia, Philip
AU  - Cavicchia P
AD  - Florida Department of Health, Tallahassee.
FAU - Slavinski, Sally
AU  - Slavinski S
AD  - New York City Department of Health and Mental Hygiene, Queens, New York.
FAU - White, Jennifer L
AU  - White JL
AD  - New York State Department of Health, Albany.
FAU - Owen, S Michele
AU  - Owen SM
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Petersen, Lyle R
AU  - Petersen LR
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Boyle, Coleen
AU  - Boyle C
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Meaney-Delman, Dana
AU  - Meaney-Delman D
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
FAU - Jamieson, Denise J
AU  - Jamieson DJ
AD  - Centers for Disease Control and Prevention, Atlanta, Georgia.
CN  - US Zika Pregnancy Registry Collaboration
LA  - eng
PT  - Journal Article
DEP - 20161215
PL  - United States
TA  - JAMA
JT  - JAMA
JID - 7501160
EDAT- 2016/12/14 06:00
MHDA- 2016/12/14 06:00
CRDT- 2016/12/14 06:00
AID - 2593702 [pii]
AID - 10.1001/jama.2016.19006 [doi]
PST - aheadofprint
SO  - JAMA. 2016 Dec 15. doi: 10.1001/jama.2016.19006.

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