Pregnancy Outcomes after ZIKV Infection in French Territories in the Americas
Bruno Hoen
(1, 2, 3)
,
Bruno Schaub
(4)
,
Anna L Funk
(5)
,
Vanessa Ardillon
(6)
,
Manon Boullard
(2)
,
André Cabié
(2)
,
Caroline Callier
(2)
,
Gabriel Carles
(7)
,
Sylvie Cassadou
(6)
,
Raymond Césaire
(8)
,
Maylis Douine
(2)
,
Cécile Herrmann-Storck
(1)
,
Philippe Kadhel
(1)
,
Cédric Laouénan
(9)
,
Yoann Madec
(5)
,
Alice Monthieux
(10)
,
Mathieu Nacher
(2)
,
Fatiha Najioullah
(8)
,
Dominique Rousset
(11)
,
Catherine Ryan
(1)
,
Kinda Schepers
(12)
,
Sofia Stegmann-Planchard
(13)
,
Benoît Tressières
(2)
,
Jean-Luc Voluménie
(4)
,
Samson Yassinguezo
(14)
,
Eustase Janky
(1)
,
Arnaud Fontanet
(5, 15, 16)
1
CHU Pointe-à-Pitre / Abymes [Guadeloupe]
2 CIC - Antilles Guyane - Centre d'investigation clinique Antilles-Guyane
3 UAG - Université des Antilles et de la Guyane
4 MFME [Fort de France] - Maison de la Femme de la Mère et de l'Enfant [CHU de la Martinique]
5 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology
6 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
7 Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française]
8 CHU de la Martinique [Fort de France]
9 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
10 UAG UFR SM - Université des Antilles et de la Guyane - UFR des sciences médicales
11 Institut Pasteur de la Guyane
12 MAITC EA 4537 - Maladies infectieuses et tropicales dans la Caraïbe
13 Centre Hospitalier Louis Constant Fleming
14 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
15 CGH - Center for Global Health Research and Education - Centre pour la Recherche et la Formation en Santé Mondiale
16 CNAM - Conservatoire National des Arts et Métiers [CNAM]
2 CIC - Antilles Guyane - Centre d'investigation clinique Antilles-Guyane
3 UAG - Université des Antilles et de la Guyane
4 MFME [Fort de France] - Maison de la Femme de la Mère et de l'Enfant [CHU de la Martinique]
5 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology
6 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
7 Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française]
8 CHU de la Martinique [Fort de France]
9 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
10 UAG UFR SM - Université des Antilles et de la Guyane - UFR des sciences médicales
11 Institut Pasteur de la Guyane
12 MAITC EA 4537 - Maladies infectieuses et tropicales dans la Caraïbe
13 Centre Hospitalier Louis Constant Fleming
14 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
15 CGH - Center for Global Health Research and Education - Centre pour la Recherche et la Formation en Santé Mondiale
16 CNAM - Conservatoire National des Arts et Métiers [CNAM]
Bruno Hoen
- Fonction : Auteur
- PersonId : 11357
- IdHAL : bruno-hoen
- ORCID : 0000-0003-3070-3017
- IdRef : 058486194
André Cabié
- Fonction : Auteur
- PersonId : 11222
- IdHAL : andre-cabie
- ORCID : 0000-0003-0117-3061
- IdRef : 08145094X
Maylis Douine
- Fonction : Auteur
- PersonId : 772327
- ORCID : 0000-0003-4616-6690
- IdRef : 134571533
Cédric Laouénan
- Fonction : Auteur
- PersonId : 771320
- ORCID : 0000-0002-3681-6314
- IdRef : 138946159
Yoann Madec
- Fonction : Auteur
- PersonId : 734914
- IdHAL : yoann-madec
- ORCID : 0000-0002-6201-1261
Mathieu Nacher
- Fonction : Auteur
- PersonId : 11286
- IdHAL : mathieu-nacher
- ORCID : 0000-0001-9397-3204
- IdRef : 087955512
Dominique Rousset
- Fonction : Auteur
- PersonId : 185062
- IdHAL : dominique-rousset211
- ORCID : 0000-0002-1473-3147
- IdRef : 224013033
Résumé
BACKGROUND:
The risk of congenital neurologic defects related to Zika virus (ZIKV) infection has ranged from 6 to 42% in various reports. The aim of this study was to estimate this risk among pregnant women with symptomatic ZIKV infection in French territories in the Americas.
METHODS:
From March 2016 through November 2016, we enrolled in this prospective cohort study pregnant women with symptomatic ZIKV infection that was confirmed by polymerase-chain-reaction (PCR) assay. The analysis included all data collected up to April 27, 2017, the date of the last delivery in the cohort.
RESULTS:
Among the 555 fetuses and infants in the 546 pregnancies included in the analysis, 28 (5.0%) were not carried to term or were stillborn, and 527 were born alive. Neurologic and ocular defects possibly associated with ZIKV infection were seen in 39 fetuses and infants (7.0%; 95% confidence interval, 5.0 to 9.5); of these, 10 were not carried to term because of termination of pregnancy for medical reasons, 1 was stillborn, and 28 were live-born. Microcephaly (defined as head circumference more than 2 SD below the mean for sex and gestational age) was detected in 32 fetuses and infants (5.8%), of whom 9 (1.6%) had severe microcephaly (more than 3 SD below the mean). Neurologic and ocular defects were more common when ZIKV infection occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001).
CONCLUSIONS:
Among pregnant women with symptomatic, PCR-confirmed ZIKV infection, birth defects possibly associated with ZIKV infection were present in 7% of fetuses and infants. Defects occurred more frequently in fetuses and infants whose mothers had been infected early in pregnancy. Longer-term follow-up of infants is required to assess any manifestations not detected at birth. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT02916732 .).