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Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018
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Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
All images from Centers for Disease Control and Prevention
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
The analysis included 1450 infants (from the 4800 pregnancies with confirmed or suspected Zika infection) who were at least 1 year old and had some reported follow-up care. About 1 in 7 infants (14%) had one or more health problems possibly caused by Zika, as reported to the US Zika Pregnancy and Infant Registry.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
The report found that 6% of the infants had Zika-associated birth defects, including calcifications and damaged or missing structures in the brain, eye anomalies such as microphthalmia, and microcephaly.
Furthermore, 9% had neurodevelopmental problems possibly caused by Zika. These outcomes included abnormalities in hearing, vision, movement, swallowing, and muscle tone, as well as congenital contractures, seizures, developmental delay based on standardized screening or evaluation, and postnatal-onset microcephaly.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
CDC's infant guidance includes recommendations for testing infants for congenital Zika infection and clinical management recommendations for infants with evidence of Zika virus infection, both with and without apparent birth defects, to ensure careful screening and monitoring of infant development. For infants with congenital Zika virus infection, care is focused on diagnosing and managing conditions that are present and addressing problems as they arise.
In this report, many infants, both those with health issues and those who appeared healthy, did not receive all of the recommended care.
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
An encouraging finding was that 95% of the infants received the recommended physical exam. The standard evaluation for all infants during routine preventive pediatric care comprises a comprehensive physical exam, including head circumference measurement, and immunizations at each subsequent well-child visit.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
Developmental screening was conducted in only 76% of the infants. It's recommended that infants be screened with an age-appropriate and validated developmental screening tool.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
Only 60% of the infants received the recommended brain imaging after birth. All infants born to mothers who had Zika during pregnancy should receive a head ultrasound within the first month of life.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
Contrary to guidelines, less than half (48%) of the Zika-exposed infants received the recommended hearing screening—the auditory brainstem response (ABR) test. All infants should receive a hearing exam using ABR at birth or by 1 month of age. If the initial hearing exam was passed using only the otoacoustic emissions method, infants should be referred for automated ABR by age 1 month.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
Even fewer (36%) of the infants received the recommended eye examination. Zika-exposed infants should undergo a comprehensive ophthalmologic exam by age 1 month, administered by an ophthalmologist experienced in infant assessment and intervention.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
Without evaluation, some health problems may not be detected or treated. Monitoring and evaluation of children with congenital Zika virus exposure is essential to ensure early detection of and early referral to intervention services that might improve outcomes.
Healthcare providers can:
Ask every mother about possible Zika exposure during pregnancy, even if her baby appears healthy.
Share Zika test results with all healthcare providers of both mother and baby.
Provide recommended pediatric follow-up care and referrals, including early intervention services. Report health information about babies and young children affected by Zika during pregnancy to their state, local, or territorial health department, even if they appear healthy.
Infant Outcomes of Zika in Pregnancy: New Data
Karen N. Polen, MPH; Dana Meaney-Delman, MD | November 5, 2018 | Contributor Information
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Contributor Information
Kara N. Polen, MPH
Health Scientist
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: Kara N. Polen, MPH, has disclosed no relevant financial relationships.
Dana Meaney-Delman, MD
Acting Branch Chief
Prevention Research and Translation Branch
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: Dana Meaney-Delman, MD, has disclosed no relevant financial relationships.
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References
Rice ME, Galang RR, Roth NM, et al. Vital Signs: Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection — U.S. Territories and freely associated states, 2018. MMWR Morb Mortal Wkly Rep. 2018;67:858-867. Source Accessed October 10, 2018.
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