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2016年1月1日至2017年4月25日美国属地孕期孕妇感染寨卡病毒后的妊娠结局

Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy - U.S. Territories, January 1, 2016-April 25, 2017.

作者信息

Shapiro-Mendoza Carrie K, Rice Marion E, Galang Romeo R, Fulton Anna C, VanMaldeghem Kelley, Prado Miguel Valencia, Ellis Esther, Anesi Magele Scott, Simeone Regina M, Petersen Emily E, Ellington Sascha R, Jones Abbey M, Williams Tonya, Reagan-Steiner Sarah, Perez-Padilla Janice, Deseda Carmen C, Beron Andrew, Tufa Aifili John, Rosinger Asher, Roth Nicole M, Green Caitlin, Martin Stacey, Lopez Camille Delgado, deWilde Leah, Goodwin Mary, Pagano H Pamela, Mai Cara T, Gould Carolyn, Zaki Sherif, Ferrer Leishla Nieves, Davis Michelle S, Lathrop Eva, Polen Kara, Cragan Janet D, Reynolds Megan, Newsome Kimberly B, Huertas Mariam Marcano, Bhatangar Julu, Quiñones Alma Martinez, Nahabedian John F, Adams Laura, Sharp Tyler M, Hancock W Thane, Rasmussen Sonja A, Moore Cynthia A, Jamieson Denise J, Munoz-Jordan Jorge L, Garstang Helentina, Kambui Afeke, Masao Carolee, Honein Margaret A, Meaney-Delman Dana

出版信息

MMWR Morb Mortal Wkly Rep. 2017 Jun 16;66(23):615-621. doi: 10.15585/mmwr.mm6623e1.

Abstract

Pregnant women living in or traveling to areas with local mosquito-borne Zika virus transmission are at risk for Zika virus infection, which can lead to severe fetal and infant brain abnormalities and microcephaly (1). In February 2016, CDC recommended 1) routine testing for Zika virus infection of asymptomatic pregnant women living in areas with ongoing local Zika virus transmission at the first prenatal care visit, 2) retesting during the second trimester for women who initially test negative, and 3) testing of pregnant women with signs or symptoms consistent with Zika virus disease (e.g., fever, rash, arthralgia, or conjunctivitis) at any time during pregnancy (2). To collect information about pregnant women with laboratory evidence of recent possible Zika virus infection* and outcomes in their fetuses and infants, CDC established pregnancy and infant registries (3). During January 1, 2016-April 25, 2017, U.S. territories with local transmission of Zika virus reported 2,549 completed pregnancies (live births and pregnancy losses at any gestational age) with laboratory evidence of recent possible Zika virus infection; 5% of fetuses or infants resulting from these pregnancies had birth defects potentially associated with Zika virus infection (4,5). Among completed pregnancies with positive nucleic acid tests confirming Zika infection identified in the first, second, and third trimesters, the percentage of fetuses or infants with possible Zika-associated birth defects was 8%, 5%, and 4%, respectively. Among liveborn infants, 59% had Zika laboratory testing results reported to the pregnancy and infant registries. Identification and follow-up of infants born to women with laboratory evidence of recent possible Zika virus infection during pregnancy permits timely and appropriate clinical intervention services (6).

摘要

居住在或前往有本地蚊媒传播寨卡病毒的地区的孕妇有感染寨卡病毒的风险,这可能导致严重的胎儿和婴儿脑部异常及小头畸形(1)。2016年2月,美国疾病控制与预防中心(CDC)建议:1)对居住在本地持续传播寨卡病毒地区的无症状孕妇,在首次产前检查时进行寨卡病毒感染的常规检测;2)对初次检测呈阴性的孕妇,在孕中期进行重新检测;3)对在孕期任何时候出现与寨卡病毒病相符的体征或症状(如发热、皮疹、关节痛或结膜炎)的孕妇进行检测(2)。为收集有关近期可能感染寨卡病毒并有实验室证据的孕妇及其胎儿和婴儿结局的信息,CDC建立了妊娠和婴儿登记系统(3)。在2016年1月1日至2017年4月25日期间,有本地寨卡病毒传播的美国属地报告了2549例已完成妊娠(活产和任何孕周的妊娠丢失),这些妊娠有近期可能感染寨卡病毒的实验室证据;这些妊娠所产胎儿或婴儿中有5%患有可能与寨卡病毒感染相关的出生缺陷(4,5)。在孕早期、孕中期和孕晚期确诊为寨卡病毒感染的核酸检测呈阳性的已完成妊娠中,可能与寨卡病毒相关的出生缺陷胎儿或婴儿的比例分别为8%、5%和4%。在活产婴儿中,59%的婴儿有寨卡病毒实验室检测结果报告给妊娠和婴儿登记系统。对孕期有近期可能感染寨卡病毒并有实验室证据的妇女所生婴儿进行识别和随访,有助于及时提供适当的临床干预服务(6)。

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