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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2020; 80(01): 60-65
DOI: 10.1055/a-0972-2052
GebFra Science
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Zika Virus and Pregnancy: Association between Acute Infection and Microcephaly in Newborns in the State of Rio de Janeiro, Brazil

Zikavirus und Schwangerschaft: Assoziation zwischen akuter Infektion und Mikrozephalie bei Neugeborenen im Bundesstaat Rio de Janeiro, Brasilien
Alessandra Mendelski Pereira
1   Perinatal Unit, State University of Rio de Janeiro (UERJ), Rio de Janeiro-RJ, Brazil
,
Edward Araujo Júnior
2   Department of Obstetrics, Paulista School of Medicine – Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil
3   Medical course, Municipal University of São Caetano do Sul (USCS), São Paulo-SP, Brazil
,
Heron Werner
4   Department of Radiology, Clínica de Diagnóstico por Imagem (CPDI), Rio de Janeiro-RJ, Brazil
,
Denise Leite Maia Monteiro
1   Perinatal Unit, State University of Rio de Janeiro (UERJ), Rio de Janeiro-RJ, Brazil
› Author Affiliations
Further Information

Publication History

received 20 June 2019
revised 06 July 2019

accepted 09 July 2019

Publication Date:
13 January 2020 (online)

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Abstract

Introduction Aim of the study was to evaluate the association between microcephaly and acute infection with Zika virus (ZIKV) in pregnant women in the state of Rio de Janeiro, Brazil. Infection was confirmed by laboratory testing.

Materials and Methods A cross-sectional retrospective study of pregnant women with symptoms occurring between 2015 and 2016 suggestive of acute ZIKV infection was carried out, with confirmation of infection done by blood or urine RT-PCR. The relative proportions of categorical variables were calculated for two distinct groups: pregnant women whose newborns had microcephaly and pregnant women who gave birth to infants without microcephaly. Confidence intervals with a 95% level of agreement were estimated for the relative ratios.

Results A total of 1609 pregnant women with a mean age of 26.4 ± 6.5 years were evaluated. As regards the time of acute infection, 19.6% (316) of cases occurred in the first trimester of pregnancy. Nineteen (76%) of the 25 cases with microcephaly (1.5%) were associated with an infection contracted in the first trimester of pregnancy (p < 0.001, OR = 13.7, 95% CI: 5.6 – 37.7). 48% (12/25) of the newborns with microcephaly had a birth weight of < 2500 grams, while only 7% (116/1597) of the group of newborns without microcephaly had a similarly low birth weight (p < 0.001, OR = 11.7, 95% CI: 5.2 – 26.2). Logistic regression showed that a birth weight of < 2500 g (OR = 12.54) and ZIKV infection in the first trimester of pregnancy (OR = 14.05) were associated with microcephaly (area under ROC curve = 0.86).

Conclusion Acute ZIKV infection in the first trimester of pregnancy and low birth weight are associated with microcephaly.

Zusammenfassung

Einleitung Ziel dieser Studie war es, die Assoziation zwischen Mikrozephalie und akuter Infektion mit Zikavirus (ZIKV) bei schwangeren Frauen im Bundesstaat Rio de Janeiro, Brasilien zu untersuchen. Die Infektion wurde durch Laboruntersuchungen bestätigt.

Material und Methoden Es wurde eine retrospektive Querschnittsstudie von schwangeren Frauen mit Symptomen, die zwichen 2015 und 2016 auftraten und die auf eine Infektion mit ZIKV hindeuteten, durchgeführt. Die Infektion wurde mittels RT-PCR von Blut- bzw. Urinproben bestätigt. Die relativen Anteile der kategorischen Variablen wurden für 2 verschiedenen Gruppen kalkuliert: schwangere Frauen, die Neugeborene mit Mikrozephalie zur Welt brachten, und schwangere Frauen, deren Kinder keine Mikrozephalie aufwiesen. Die 95%-Konfidenzintervalle für die relativen Anteile wurden geschätzt.

Ergebnisse Insgesamt wurden 1609 schwangere Frauen mit einem Durchschnittsalter von 26,4 ± 6,5 Jahren evaluiert. Was den Zeitpunkt der akuten Infektion angeht, stellte sich heraus, dass 19,6% (316) der Infektionen im 1. Schwangerschaftstrimenon aufgetreten waren. Bei 25 Fällen mit Mikrozephalie (1,5%) bestand bei 19 (76%) eine Assoziation mit einer Ansteckung im 1. Trimester der Schwangerschaft (p < 0,001; OR = 13,7; 95%-KI [5,6 – 37,7]). Von den Neugeborenen mit Mikrozephalie hatten 48% (12/25) ein Geburtsgewicht von < 2500 g, wohingegen nur 7% (116/1597) der Neugeborenen in der Gruppe ohne Mikrozephalie ein ähnlich niedriges Geburtsgewicht aufwiesen (p < 0,001; OR = 11,7; 95%-KI [5,2 – 26,2]). Das logistische Regressionsmodell zeigte, dass ein Geburtsgewicht von < 2500 g (OR = 12,54) sowie eine ZIKV-Infektion im 1. Trimenon der Schwangerschaft (OR = 14,05) mit Mikrozephalie assoziiert sind (Fläche unter der ROC-Kurve = 0,86).

Schlussfolgerung Akute Infektion mit ZIKV im 1.  Schwangerschaftstrimester und ein niedriges Geburtsgewicht sind mit dem Auftreten von Mikrozephalie assoziiert.

Key words

congenital infection - Zika virus - microcephaly - low birth weight - first trimester of pregnancy

Schlüsselwörter

kongenitale Infektion - Zikavirus - Mikrozephalie - niedriges Geburtsgewicht - erstes Schwangerschaftstrimenon
 

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