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Published in: Reproductive Health 1/2017

Open Access 01-12-2017 | Review

Zika virus infection in pregnancy: a systematic review of disease course and complications

Authors: Ezinne C. Chibueze, Veronika Tirado, Katharina da Silva Lopes, Olukunmi O. Balogun, Yo Takemoto, Toshiyuki Swa, Amarjargal Dagvadorj, Chie Nagata, Naho Morisaki, Clara Menendez, Erika Ota, Rintaro Mori, Olufemi T. Oladapo

Published in: Reproductive Health | Issue 1/2017

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Abstract

Objectives

To characterize maternal Zika virus (ZIKV) infection and complement the evidence base for the WHO interim guidance on pregnancy management in the context of ZIKV infection.

Methods

We searched the relevant database from inception until March 2016. Two review authors independently screened and assessed full texts of eligible reports and extracted data from relevant studies. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) and the National Institute of Health (NIH) tool for observational studies and case series/reports, respectively.

Results

Among 142 eligible full-text articles, 18 met the inclusion criteria (13 case series/reports and five cohort studies). Common symptoms among pregnant women with suspected/confirmed ZIKV infection were fever, rash, and arthralgia. One case of Guillain-Barré syndrome was reported among ZIKV-infected mothers, no other case of severe maternal morbidity or mortality reported. Complications reported in association with maternal ZIKV infection included a broad range of fetal and newborn neurological and ocular abnormalities; fetal growth restriction, stillbirth, and perinatal death. Microcephaly was the primary neurological complication reported in eight studies, with an incidence of about 1% among newborns of ZIKV infected women in one study.

Conclusion

Given the extensive and variable fetal and newborn presentations/complications associated with prenatal ZIKV infection, and the dearth of information provided, knowledge gaps are evident. Further research and comprehensive reporting may provide a better understanding of ZIKV infection in pregnancy and attendant maternal/fetal complications. This knowledge could inform the creation of effective and evidence-based strategies, guidelines and recommendations aimed at the management of maternal ZIKV infection. Adherence to current best practice guidelines for prenatal care among health providers is encouraged, in the context of maternal ZIKV infection.
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Literature
1.
go back to reference Haddow A, Williams M, Woodall J, Simpson D, Goma L. Twelve isolations of Zika virus from Aedes (Stegomyia) africanus (Theobald) taken in and above a Uganda forest. Bull World Health Organ. 1964;31(1):57.PubMedPubMedCentral Haddow A, Williams M, Woodall J, Simpson D, Goma L. Twelve isolations of Zika virus from Aedes (Stegomyia) africanus (Theobald) taken in and above a Uganda forest. Bull World Health Organ. 1964;31(1):57.PubMedPubMedCentral
2.
go back to reference Dick G, Haddow A. Uganda S virus: A hitherto unrecorded virus isolated from mosquitoes in Uganda..(I). Isolation and pathogenicity. Trans R Soc Trop Med Hyg. 1952;46(6):600–18.CrossRefPubMed Dick G, Haddow A. Uganda S virus: A hitherto unrecorded virus isolated from mosquitoes in Uganda..(I). Isolation and pathogenicity. Trans R Soc Trop Med Hyg. 1952;46(6):600–18.CrossRefPubMed
3.
go back to reference Kindhauser MK, Allen T, Frank V, Santhana RS, Dye C. Zika: the origin and spread of a mosquito-borne virus. Bull World Health Organ. 2016;94(9):675–686C. Epub 2016 Feb 9.CrossRefPubMedPubMedCentral Kindhauser MK, Allen T, Frank V, Santhana RS, Dye C. Zika: the origin and spread of a mosquito-borne virus. Bull World Health Organ. 2016;94(9):675–686C. Epub 2016 Feb 9.CrossRefPubMedPubMedCentral
5.
go back to reference Macnamara F. Zika virus: a report on three cases of human infection during an epidemic of jaundice in Nigeria. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1954;48(2):139–45.CrossRefPubMed Macnamara F. Zika virus: a report on three cases of human infection during an epidemic of jaundice in Nigeria. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1954;48(2):139–45.CrossRefPubMed
6.
go back to reference Duffy MR, Chen T-H, Hancock WT, Powers AM, Kool JL, Lanciotti RS, et al. Zika virus outbreak on Yap Island, federated states of Micronesia. N Engl J Med. 2009;360(24):2536–43.CrossRefPubMed Duffy MR, Chen T-H, Hancock WT, Powers AM, Kool JL, Lanciotti RS, et al. Zika virus outbreak on Yap Island, federated states of Micronesia. N Engl J Med. 2009;360(24):2536–43.CrossRefPubMed
7.
go back to reference Gatherer D, Kohl A. Zika virus: A previously slow pandemic spreads rapidly through the Americas. J Gen Virol. 2016;97(2):269–73.CrossRefPubMed Gatherer D, Kohl A. Zika virus: A previously slow pandemic spreads rapidly through the Americas. J Gen Virol. 2016;97(2):269–73.CrossRefPubMed
8.
go back to reference Paixao ES, Barreto F, da Gloria Teixeira M, da Conceicao N, Costa M, Rodrigues LC. History, Epidemiology, and Clinical Manifestations of Zika: A Systematic Review. Am J Public Health. 2016;106(4):606–12.CrossRefPubMedPubMedCentral Paixao ES, Barreto F, da Gloria Teixeira M, da Conceicao N, Costa M, Rodrigues LC. History, Epidemiology, and Clinical Manifestations of Zika: A Systematic Review. Am J Public Health. 2016;106(4):606–12.CrossRefPubMedPubMedCentral
9.
10.
go back to reference Eurosurveillance editorial team. Resources and latest news about zika virus disease available from ECDC. Euro Surveill. 2016;21(5):32.CrossRef Eurosurveillance editorial team. Resources and latest news about zika virus disease available from ECDC. Euro Surveill. 2016;21(5):32.CrossRef
11.
go back to reference Hills SL, Russell K, Hennessey M, Williams C, Oster AM, Fischer M, et al. Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of Ongoing Transmission - Continental United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(8):215–6.CrossRefPubMed Hills SL, Russell K, Hennessey M, Williams C, Oster AM, Fischer M, et al. Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of Ongoing Transmission - Continental United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(8):215–6.CrossRefPubMed
12.
go back to reference Goorhuis A, von Eije KJ, Douma RA, Rijnberg N, van Vugt M, Stijnis C, et al. Zika virus and the risk of imported infection in returned travelers: Implications for clinical care. Travel Med Infect Dis. 2016;14(1):13–5.CrossRefPubMed Goorhuis A, von Eije KJ, Douma RA, Rijnberg N, van Vugt M, Stijnis C, et al. Zika virus and the risk of imported infection in returned travelers: Implications for clinical care. Travel Med Infect Dis. 2016;14(1):13–5.CrossRefPubMed
13.
go back to reference Fauci AS, Morens DM. Zika virus in the americas-yet another arbovirus threat. N Engl J Med. 2016;374(7):601–4.CrossRefPubMed Fauci AS, Morens DM. Zika virus in the americas-yet another arbovirus threat. N Engl J Med. 2016;374(7):601–4.CrossRefPubMed
14.
go back to reference Yakob L, Walker T. Zika virus outbreak in the Americas: the need for novel mosquito control methods. Lancet Glob Health. 2016;4(3):e148–e9.CrossRefPubMed Yakob L, Walker T. Zika virus outbreak in the Americas: the need for novel mosquito control methods. Lancet Glob Health. 2016;4(3):e148–e9.CrossRefPubMed
15.
go back to reference Weaver SC, Reisen WK. Present and future arboviral threats. Antiviral research. 2010;85(2):328–45.CrossRefPubMed Weaver SC, Reisen WK. Present and future arboviral threats. Antiviral research. 2010;85(2):328–45.CrossRefPubMed
16.
go back to reference Chang C, Ortiz K, Ansari A, Gershwin ME. The Zika outbreak of the 21st century. J Autoimmun. 2016;68:1–13.CrossRefPubMed Chang C, Ortiz K, Ansari A, Gershwin ME. The Zika outbreak of the 21st century. J Autoimmun. 2016;68:1–13.CrossRefPubMed
17.
go back to reference Victora CG, Schuler-Faccini L, Matijasevich A, Ribeiro E, Pessoa A, Barros FC. Microcephaly in Brazil: How to interpret reported numbers? The Lancet. 2016;387(10019):621–4.CrossRef Victora CG, Schuler-Faccini L, Matijasevich A, Ribeiro E, Pessoa A, Barros FC. Microcephaly in Brazil: How to interpret reported numbers? The Lancet. 2016;387(10019):621–4.CrossRef
20.
go back to reference Chibueze EC, Parsons AJ, Ota E, Swa T, Oladapo OT, Mori R. Prophylactic antibiotics for manual removal of retained placenta during vaginal birth: a systematic review of observational studies and meta-analysis. BMC Pregnancy Childbirth. 2015;15(1):313.CrossRefPubMedPubMedCentral Chibueze EC, Parsons AJ, Ota E, Swa T, Oladapo OT, Mori R. Prophylactic antibiotics for manual removal of retained placenta during vaginal birth: a systematic review of observational studies and meta-analysis. BMC Pregnancy Childbirth. 2015;15(1):313.CrossRefPubMedPubMedCentral
21.
go back to reference Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. Euro Surveill. 2014;19(13). Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. Euro Surveill. 2014;19(13).
22.
go back to reference McCarthy M. Severe eye damage in infants with microcephaly is presumed to be due to Zika virus. Bmj. 2016;352:i855.CrossRefPubMed McCarthy M. Severe eye damage in infants with microcephaly is presumed to be due to Zika virus. Bmj. 2016;352:i855.CrossRefPubMed
23.
go back to reference Reyna-Villasmil E, Lopez-Sanchez G, Santos-Bolivar J. [Guillain-Barre syndrome due to Zika virus during pregnancy]. Med Clin (Barc). 2016;146(7):331–2. Sindrome de Guillain-Barre debido al virus del Zika durante el embarazo.CrossRef Reyna-Villasmil E, Lopez-Sanchez G, Santos-Bolivar J. [Guillain-Barre syndrome due to Zika virus during pregnancy]. Med Clin (Barc). 2016;146(7):331–2. Sindrome de Guillain-Barre debido al virus del Zika durante el embarazo.CrossRef
24.
go back to reference Villamil-Gómez WE, Mendoza-Guete A, Villalobos E, González-Arismendy E, Uribe-García AM, Castellanos JE, et al. Diagnosis, management and follow-up of pregnant women with Zika virus infection: A preliminary report of the ZIKERNCOL cohort study on Sincelejo, Colombia. Travel Medicine and Infectious Disease. 2016((Villamil-Gómez W.E.) Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Sucre, Colombia). Villamil-Gómez WE, Mendoza-Guete A, Villalobos E, González-Arismendy E, Uribe-García AM, Castellanos JE, et al. Diagnosis, management and follow-up of pregnant women with Zika virus infection: A preliminary report of the ZIKERNCOL cohort study on Sincelejo, Colombia. Travel Medicine and Infectious Disease. 2016((Villamil-Gómez W.E.) Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Sucre, Colombia).
25.
go back to reference Thomas DL, Sharp TM, Torres J, Armstrong PA, Munoz-Jordan J, Ryff KR, et al. Local transmission of zika virus - Puerto Rico, november 23, 2015-january 28, 2016. MMWR MorbMortal Wkly Rep. 2016;65(6):154–8.CrossRef Thomas DL, Sharp TM, Torres J, Armstrong PA, Munoz-Jordan J, Ryff KR, et al. Local transmission of zika virus - Puerto Rico, november 23, 2015-january 28, 2016. MMWR MorbMortal Wkly Rep. 2016;65(6):154–8.CrossRef
26.
go back to reference Schuler-Faccini L, Ribeiro EM, Feitosa IML, Horovitz DDG, Cavalcanti DP, Pessoa A, et al. Possible association between zika virus infection and microcephaly -- Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(3):59–62.CrossRefPubMed Schuler-Faccini L, Ribeiro EM, Feitosa IML, Horovitz DDG, Cavalcanti DP, Pessoa A, et al. Possible association between zika virus infection and microcephaly -- Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(3):59–62.CrossRefPubMed
27.
go back to reference Brasil Martines R, Bhatnagar J, Kelly Keating M, Silva-Flannery L, Muehlenbachs A, Gary J, et al. Evidence of zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses - Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(6):159–60.CrossRef Brasil Martines R, Bhatnagar J, Kelly Keating M, Silva-Flannery L, Muehlenbachs A, Gary J, et al. Evidence of zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses - Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(6):159–60.CrossRef
28.
go back to reference de Paula FB, de Oliveira Dias JR, Prazeres J, Sacramento GA, Ko AI, Maia M, et al. Ocular findings in infants with microcephaly associated with presumed Zika virus congenital infection in Salvador. Brazil JAMA ophthalmology. 2016;134(5):529–35.CrossRef de Paula FB, de Oliveira Dias JR, Prazeres J, Sacramento GA, Ko AI, Maia M, et al. Ocular findings in infants with microcephaly associated with presumed Zika virus congenital infection in Salvador. Brazil JAMA ophthalmology. 2016;134(5):529–35.CrossRef
29.
go back to reference Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WTGH, do Carmo GMI, Henriques CMP, Coelho GE, et al. Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy - Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(9):242–7.CrossRefPubMed Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WTGH, do Carmo GMI, Henriques CMP, Coelho GE, et al. Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy - Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(9):242–7.CrossRefPubMed
30.
go back to reference Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol. 2016;47(1):6–7.CrossRefPubMed Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol. 2016;47(1):6–7.CrossRefPubMed
31.
go back to reference Cauchemez S, Besnard M, Bompard P, Dub T, Guillemette-Artur P, Eyrolle-Guignot D, et al. Association between Zika virus and microcephaly in French Polynesia, 2013–15: a retrospective study. The Lancet. 2016;387(10033):2125–32.CrossRef Cauchemez S, Besnard M, Bompard P, Dub T, Guillemette-Artur P, Eyrolle-Guignot D, et al. Association between Zika virus and microcephaly in French Polynesia, 2013–15: a retrospective study. The Lancet. 2016;387(10033):2125–32.CrossRef
32.
go back to reference Calvet G, Aguiar RS, Melo AS, Sampaio SA, de Filippis I, Fabri A, et al. Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study. The Lancet Infectious diseases. 2016;16(6):653–60.CrossRefPubMed Calvet G, Aguiar RS, Melo AS, Sampaio SA, de Filippis I, Fabri A, et al. Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study. The Lancet Infectious diseases. 2016;16(6):653–60.CrossRefPubMed
33.
go back to reference Brasil P, Pereira J, Jose P, Raja Gabaglia C, Damasceno L, Wakimoto M, Ribeiro Nogueira RM, et al. Zika virus infection in pregnant women in Rio de Janeiro—preliminary report. N Engl J Med. 2016;375:2321–34.CrossRefPubMed Brasil P, Pereira J, Jose P, Raja Gabaglia C, Damasceno L, Wakimoto M, Ribeiro Nogueira RM, et al. Zika virus infection in pregnant women in Rio de Janeiro—preliminary report. N Engl J Med. 2016;375:2321–34.CrossRefPubMed
34.
go back to reference Ventura CV, Maia M, Ventura BV, Linden VVD, Araujo EB, Ramos RC, et al. Ophthalmological findings in infants with microcephaly and presumable intra-uterus Zika virus infection. Arq Bras Oftalmol. 2016;79(1):1–3.CrossRefPubMed Ventura CV, Maia M, Ventura BV, Linden VVD, Araujo EB, Ramos RC, et al. Ophthalmological findings in infants with microcephaly and presumable intra-uterus Zika virus infection. Arq Bras Oftalmol. 2016;79(1):1–3.CrossRefPubMed
35.
go back to reference Sarno M, Sacramento GA, Khouri R, do Rosario MS, Costa F, Archanjo G, et al. Zika Virus Infection and Stillbirths: A Case of Hydrops Fetalis, Hydranencephaly and Fetal Demise. PLoS Negl Trop Dis. 2016;10(2):e0004517.CrossRefPubMedPubMedCentral Sarno M, Sacramento GA, Khouri R, do Rosario MS, Costa F, Archanjo G, et al. Zika Virus Infection and Stillbirths: A Case of Hydrops Fetalis, Hydranencephaly and Fetal Demise. PLoS Negl Trop Dis. 2016;10(2):e0004517.CrossRefPubMedPubMedCentral
36.
go back to reference Meaney-Delman D, Hills SL, Williams C, Galang RR, Iyengar P, Hennenfent AK, et al. Zika Virus Infection Among U.S. Pregnant Travelers - August 2015-February 2016. MMWR: Morbidity & Mortality Weekly Report. 2016;65(8):211–4. Meaney-Delman D, Hills SL, Williams C, Galang RR, Iyengar P, Hennenfent AK, et al. Zika Virus Infection Among U.S. Pregnant Travelers - August 2015-February 2016. MMWR: Morbidity & Mortality Weekly Report. 2016;65(8):211–4.
37.
go back to reference Mlakar J, Korva M, Tul N, Popović M, PoIjšak-Prijatelj M, Mraz J, et al. Zika Virus Associated with Microcephaly. N Engl J Med. 2016;374(10):951–8.CrossRefPubMed Mlakar J, Korva M, Tul N, Popović M, PoIjšak-Prijatelj M, Mraz J, et al. Zika Virus Associated with Microcephaly. N Engl J Med. 2016;374(10):951–8.CrossRefPubMed
38.
go back to reference Ventura CV, Maia M, Bravo-Filho V, Góis AL, Belfort R. Zika virus in Brazil and macular atrophy in a child with microcephaly. The Lancet. 2016;387(10015):228.CrossRef Ventura CV, Maia M, Bravo-Filho V, Góis AL, Belfort R. Zika virus in Brazil and macular atrophy in a child with microcephaly. The Lancet. 2016;387(10015):228.CrossRef
39.
go back to reference Zika virus infection: global update on epidemiology and potentially associated clinical manifestations. Wkly Epidemiol Rec. 2016;91(7):73–81. Zika virus infection: global update on epidemiology and potentially associated clinical manifestations. Wkly Epidemiol Rec. 2016;91(7):73–81.
40.
go back to reference Ioos S, Mallet H-P, Goffart IL, Gauthier V, Cardoso T, Herida M. Current Zika virus epidemiology and recent epidemics. Med Mal Infect. 2014;44(7):302–7.CrossRefPubMed Ioos S, Mallet H-P, Goffart IL, Gauthier V, Cardoso T, Herida M. Current Zika virus epidemiology and recent epidemics. Med Mal Infect. 2014;44(7):302–7.CrossRefPubMed
41.
go back to reference Boeuf P, Drummer HE, Richards JS, Scoullar JS, Beeson JS. The global threat of Zika virus to pregnancy: epidemiology, clinical perspectives, mechanisms, and impact. BMC Medicine. 2016;14(1):112.CrossRefPubMedPubMedCentral Boeuf P, Drummer HE, Richards JS, Scoullar JS, Beeson JS. The global threat of Zika virus to pregnancy: epidemiology, clinical perspectives, mechanisms, and impact. BMC Medicine. 2016;14(1):112.CrossRefPubMedPubMedCentral
Metadata
Title
Zika virus infection in pregnancy: a systematic review of disease course and complications
Authors
Ezinne C. Chibueze
Veronika Tirado
Katharina da Silva Lopes
Olukunmi O. Balogun
Yo Takemoto
Toshiyuki Swa
Amarjargal Dagvadorj
Chie Nagata
Naho Morisaki
Clara Menendez
Erika Ota
Rintaro Mori
Olufemi T. Oladapo
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2017
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-017-0285-6

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