Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil

Pereira, Jose Paulo; Nielsen-Saines, Karin; Sperling, Jeffrey; Maykin, Melanie M.; Damasceno, Luana; Cardozo, Renan Fonseca; Valle, Helena Abreu; Dutra, Beatriz Ribeiro Torres; Gama, Helder Dotta; Adachi, Kristina; Zin, Andrea A.; Tsui, Irena; Vasconcelos, Zilton Farias Meira de; Brasil, Patricia; Moreira, Maria E.; Gaw, Stephanie L.

Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil

Detalhes bibliográficos
Autor(a) principal:	Pereira, Jose Paulo
Data de Publicação:	2018
Outros Autores:	Nielsen-Saines, Karin, Sperling, Jeffrey, Maykin, Melanie M., Damasceno, Luana, Cardozo, Renan Fonseca, Valle, Helena Abreu, Dutra, Beatriz Ribeiro Torres, Gama, Helder Dotta, Adachi, Kristina, Zin, Andrea A., Tsui, Irena, Vasconcelos, Zilton Farias Meira de, Brasil, Patricia, Moreira, Maria E., Gaw, Stephanie L.
Tipo de documento:	Artigo
Idioma:	eng
Título da fonte:	Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo:	https://www.arca.fiocruz.br/handle/icict/32971
Resumo:	2020-05-07

Metadados do item

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spelling	Pereira, Jose PauloNielsen-Saines, KarinSperling, JeffreyMaykin, Melanie M.Damasceno, LuanaCardozo, Renan FonsecaValle, Helena AbreuDutra, Beatriz Ribeiro TorresGama, Helder DottaAdachi, KristinaZin, Andrea A.Tsui, IrenaVasconcelos, Zilton Farias Meira deBrasil, PatriciaMoreira, Maria E.Gaw, Stephanie L.2019-05-07T12:49:01Z2019-05-07T12:49:01Z2018PEREIRA, 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 2018.2574-3805https://www.arca.fiocruz.br/handle/icict/3297110.1001/jamanetworkopen.2018.6529engAmerican Medical AssociationAssociation of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2020-05-07Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.University of California. Department of Pediatrics. Division of Pediatric Infectious Diseases. Los Angeles, CA, USA.University of California. Department of Obstetrics, Gynecology, and Reproductive Sciences. Division of Maternal-Fetal Medicine. San Francisco, CA, USA.University of California. Department of Obstetrics, Gynecology, and Reproductive Sciences. Division of Maternal-Fetal Medicine. San Francisco, CA, USA.Fundação Oswaldo Cruz. Instituto de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.University of California. Department of Pediatrics. Division of Pediatric Infectious Diseases. Los Angeles, CA, USA.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.University of California. Jules Stein Eye Institute. Retina Division. Los Angeles, CA, USA.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.University of California. Department of Obstetrics, Gynecology, and Reproductive Sciences. Division of Maternal-Fetal Medicine. San Francisco, CA, USA.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.Zika virus infectionPrenatal ultrasonographicAdverse neonatal outcomesPregnant womenBrazilinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83104https://www.arca.fiocruz.br/bitstream/icict/32971/1/license.txt79178e5f2a0eb066867a274556814938MD51ORIGINALve_Pereira_José_etal_INI_2018.pdfve_Pereira_José_etal_INI_2018.pdfapplication/pdf878903https://www.arca.fiocruz.br/bitstream/icict/32971/2/ve_Pereira_Jos%c3%a9_etal_INI_2018.pdf208f6dcb1c360de572772474e8f3bf9eMD52TEXTve_Pereira_José_etal_INI_2018.pdf.txtve_Pereira_José_etal_INI_2018.pdf.txtExtracted texttext/plain51743https://www.arca.fiocruz.br/bitstream/icict/32971/3/ve_Pereira_Jos%c3%a9_etal_INI_2018.pdf.txt675496e3cd567e8b790f660d578a3947MD53icict/329712021-03-24 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dc.title.pt_BR.fl_str_mv	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil
title	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil
spellingShingle	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil Pereira, Jose Paulo Zika virus infection Prenatal ultrasonographic Adverse neonatal outcomes Pregnant women Brazil
title_short	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil
title_full	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil
title_fullStr	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil
title_full_unstemmed	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil
title_sort	Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil
author	Pereira, Jose Paulo
author_facet	Pereira, Jose Paulo Nielsen-Saines, Karin Sperling, Jeffrey Maykin, Melanie M. Damasceno, Luana Cardozo, Renan Fonseca Valle, Helena Abreu Dutra, Beatriz Ribeiro Torres Gama, Helder Dotta Adachi, Kristina Zin, Andrea A. Tsui, Irena Vasconcelos, Zilton Farias Meira de Brasil, Patricia Moreira, Maria E. Gaw, Stephanie L.
author_role	author
author2	Nielsen-Saines, Karin Sperling, Jeffrey Maykin, Melanie M. Damasceno, Luana Cardozo, Renan Fonseca Valle, Helena Abreu Dutra, Beatriz Ribeiro Torres Gama, Helder Dotta Adachi, Kristina Zin, Andrea A. Tsui, Irena Vasconcelos, Zilton Farias Meira de Brasil, Patricia Moreira, Maria E. Gaw, Stephanie L.
author2_role	author author author author author author author author author author author author author author author
dc.contributor.author.fl_str_mv	Pereira, Jose Paulo Nielsen-Saines, Karin Sperling, Jeffrey Maykin, Melanie M. Damasceno, Luana Cardozo, Renan Fonseca Valle, Helena Abreu Dutra, Beatriz Ribeiro Torres Gama, Helder Dotta Adachi, Kristina Zin, Andrea A. Tsui, Irena Vasconcelos, Zilton Farias Meira de Brasil, Patricia Moreira, Maria E. Gaw, Stephanie L.
dc.subject.en.pt_BR.fl_str_mv	Zika virus infection Prenatal ultrasonographic Adverse neonatal outcomes Pregnant women Brazil
topic	Zika virus infection Prenatal ultrasonographic Adverse neonatal outcomes Pregnant women Brazil
description	2020-05-07
publishDate	2018
dc.date.issued.fl_str_mv	2018
dc.date.accessioned.fl_str_mv	2019-05-07T12:49:01Z
dc.date.available.fl_str_mv	2019-05-07T12:49:01Z
dc.type.status.fl_str_mv	info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv	info:eu-repo/semantics/article
format	article
status_str	publishedVersion
dc.identifier.citation.fl_str_mv	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.
dc.identifier.uri.fl_str_mv	https://www.arca.fiocruz.br/handle/icict/32971
dc.identifier.issn.pt_BR.fl_str_mv	2574-3805
dc.identifier.doi.none.fl_str_mv	10.1001/jamanetworkopen.2018.6529
identifier_str_mv	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. 2574-3805 10.1001/jamanetworkopen.2018.6529
url	https://www.arca.fiocruz.br/handle/icict/32971
dc.language.iso.fl_str_mv	eng
language	eng
dc.rights.driver.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	American Medical Association
publisher.none.fl_str_mv	American Medical Association
dc.source.none.fl_str_mv	reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ
instname_str	Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str	FIOCRUZ
institution	FIOCRUZ
reponame_str	Repositório Institucional da FIOCRUZ (ARCA)
collection	Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv	https://www.arca.fiocruz.br/bitstream/icict/32971/1/license.txt https://www.arca.fiocruz.br/bitstream/icict/32971/2/ve_Pereira_Jos%c3%a9_etal_INI_2018.pdf https://www.arca.fiocruz.br/bitstream/icict/32971/3/ve_Pereira_Jos%c3%a9_etal_INI_2018.pdf.txt
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bitstream.checksumAlgorithm.fl_str_mv	MD5 MD5 MD5
repository.name.fl_str_mv	Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv	repositorio.arca@fiocruz.br
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Association of prenatal ultrasonographic findings with adverse neonatal outcomes among pregnant women with Zika virus infection in Brazil

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