scholarly journals Can Zika Virus Infection in High Risk Pregnant Women Be Differentiated on the Basis of Symptoms?

Viruses ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 1263
Author(s):  
Nuria Sanchez Clemente ◽  
Elizabeth Brickley ◽  
Marcia Furquim de Almeida ◽  
Steven Witkin ◽  
Saulo Duarte Passos ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Zika Virus ◽  
Physical Symptoms ◽  
Case Definition ◽  
Zikv Infection ◽  
Risk Pregnancy ◽  
Using Data ◽  
Specific Symptoms

Zika virus (ZIKV) infection in pregnancy is associated with congenital neurological abnormalities. Our understanding of the full clinical spectrum of ZIKV infection is incomplete. Using data from this prospective cohort study consisting of 650 women attending a high-risk pregnancy clinic during the Zika virus outbreak in Brazil, we investigated the extent to which specific symptoms can be utilized to differentiate ZIKV-infected pregnant women from those with other pregnancy-related problems. All were tested for ZIKV in urine by RT–qPCR. Demographic and clinical data including physical symptoms during follow-up were recorded and analyzed with respect to Zika virus exposure status. Forty-eight (7.4%) women were positive for ZIKV by RT–qPCR. The majority (70.8%) were asymptomatic, and only four ZIKV-positive women (8.3%) reported symptoms during pregnancy that met the WHO case definition. Zika-positive and -negative women reported similar frequencies of ZIKV-like symptoms (as per the WHO definition): fever (16.7% vs. 13.6%), arthralgia/arthritis (10.4% vs. 11.3%), rash (4.2% vs. 5.3%), and conjunctivitis (2.1% vs. 3.2%). Most pregnant women positive for ZIKV in urine are asymptomatic and do not deliver a baby with microcephaly. Physical symptoms alone did not differentiate between high-risk pregnant women positive or negative for ZIKV.

scholarly journals Knowledge of Zika Virus Transmission and Its Prevention among High-Risk Pregnant Women in Brazil

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 242
Author(s):  
Lucas C. Pires ◽  
Luiza R. Dantas ◽  
Steven S. Witkin ◽  
Ana Paula A. P. Bertozzi ◽  
Rita de Cássia A. B. Dezena ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Zika Virus ◽  
Virus Transmission ◽  
Cross Sectional Study ◽  
Zikv Infection ◽  
Cross Sectional ◽  
Virus Acquisition ◽  
Need To Evaluate ◽  
The City

Recent outbreaks of Zika virus (ZIKV) infection highlight the urgent need to evaluate the efficacy of current public health measures to educate susceptible groups about how to prevent infection, modes of viral transmission, and consequences of infection. We performed a cross-sectional study in the city of Jundiaí, São-Paulo, from March 2016 to August 2017. In 315 high-risk pregnant women we evaluated the rate of ZIKV infection, knowledge of pathways of ZIKV transmission, and the use of protective measures. Data were analyzed and correlated with sociodemographic variables. The rate of ZIKV infection was 10.8%. ZIKV transmission by mosquitoes was the best-known means of virus acquisition, while transmission of ZIKV by sexual intercourse as well as mother–fetus transmission was known by less than half of the women. The use of insect repellent, reported by 53% of participants, was correlated with higher education and personal directives from health professionals. Condom use was reported by 19.5% of subjects. Improved strategies to increase awareness of ZIKV infection and its consequences, designed to appeal to specific, targeted populations, are clearly necessary to more accurately prevent the spread of this infection and diminish adverse consequences in the pregnant population.

scholarly journals The proportion of asymptomatic infections and spectrum of disease among pregnant women infected by Zika virus: systematic monitoring in French Guiana, 2016

2017 ◽  
Vol 22 (44) ◽  
Author(s):  
Claude Flamand ◽  
Camille Fritzell ◽  
Séverine Matheus ◽  
Maryvonne Dueymes ◽  
Gabriel Carles ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Zika Virus ◽  
French Guiana ◽  
Rt Pcr ◽  
Zikv Infection ◽  
Younger Women ◽  
Adjusted Risk ◽  
Adjusted Risk Ratio ◽  
Asymptomatic Infections

Zika virus (ZIKV) infection has been associated with complications during pregnancy. Although the presence of symptoms might be a risk factor for complication, the proportion of ZIKV-infected pregnant women with symptoms remains unknown. Following the emergence of ZIKV in French Guiana, all pregnancies in the territory were monitored by RT-PCR and/or detection of ZIKV antibodies. Follow-up data collected during pregnancy monitoring interviews were analysed from 1 February to 1 June 2016. We enrolled 3,050 pregnant women aged 14–48 years and 573 (19%) had laboratory-confirmed ZIKV infection. Rash, arthralgia, myalgia and conjunctival hyperaemia were more frequently observed in ZIKV-positive women; 23% of them (95% confidence interval (CI): 20–27) had at least one symptom compatible with ZIKV infection. Women 30 years and older were significantly more likely to have symptoms than younger women (28% vs 20%). The proportion of symptomatic infections varied from 17% in the remote interior to 35% in the urbanised population near the coast (adjusted risk ratio: 1.6; 95% CI: 1.4–1.9.). These estimates put findings on cohorts of symptomatic ZIKV-positive pregnant women into the wider context of an epidemic with mainly asymptomatic infections. The proportion of symptomatic ZIKV infections appears to vary substantially between populations.

scholarly journals Identifying possible inaccuracy in reported birth head circumference measurements among infants in the US Zika Pregnancy and Infant Registry

2021 ◽  
Author(s):  
Nicole M. Roth ◽  
Kate Russell Woodworth ◽  
Shana Godfred-Cato ◽  
Augustina M. Delaney ◽  
Samantha M. Olson ◽  
...  
Keyword(s):  
Literature Review ◽  
Expert Opinion ◽  
Birth Defects ◽  
Growth Velocity ◽  
Head Circumference ◽  
Zika Virus ◽  
Case Definition ◽  
Zikv Infection ◽  
The Us

Abstract The US Zika Pregnancy and Infant Registry (USZPIR) monitors infants born to mothers with confirmed or possible Zika virus (ZIKV) infection during pregnancy. The surveillance case definition for Zika-associated birth defects includes microcephaly based on head circumference (HC). We assessed birth and follow-up data from infants with birth HC measurements <3rd percentile and birthweight ≥10th percentile to determine possible misclassification of microcephaly.We developed a schema informed by literature review and expert opinion to identify possible HC measurement inaccuracy using HC growth velocity and neuroimaging results. Two or more HC measurements between 2-12 months of age were required for assessment. Inaccuracy in birth HC measurement was suspected if growth velocity was >3 centimeters/month in the first three months or HC was consistently >25th percentile during follow-up. Normal neuroimaging was considered supportive of HC measurement inaccuracy. Of 6,799 infants, 351 (5.2%) had Zika-associated birth defects, of which 111 had birth HC measurements <3rd percentile and birthweight ≥10th percentile. Of 84/111 infants with sufficient follow-up, 38/84 (45%) were classified as having possible inaccuracy of birth HC measurement, 19/84 (23%) had HC ≥3rd percentile on follow-up without meeting criteria for possible inaccuracy, and 27/84 (32%) had continued HC <3rd percentile. After excluding possible inaccuracies, the proportion of infants with Zika-associated birth defects including microcephaly decreased from 5.2% to 4.6%.About one-third of infants with Zika-associated birth defects had only microcephaly, but indications of possible measurement inaccuracy were common. Implementation of this schema in ZIKV infection during pregnancy studies can reduce misclassification of microcephaly.

Complexities of Zika Diagnosis and Evaluation in a U.S. Congenital Zika Program

2021 ◽  
Author(s):  
Sarah B. Mulkey ◽  
Emily Ansusinha ◽  
Caitlin Cristante ◽  
Stephanie M. Russo ◽  
Cara Biddle ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Zika Virus ◽  
Laboratory Testing ◽  
Time Frame ◽  
Mri Findings ◽  
Zikv Infection ◽  
Long Term Follow Up ◽  
Congenital Zika Syndrome ◽  
Magnetic Resonance Imaging Mri

The objective of the study was to describe the complexity of diagnosis and evaluation of Zika-exposed pregnant women/fetuses and infants in a U.S. Congenital Zika Program. Pregnant women/fetuses and/or infants referred for clinical evaluation to the Congenital Zika Program at Children’s National (Washington, DC) from January 2016 to June 2018 were included. We recorded the timing of maternal Zika-virus (ZIKV) exposure and ZIKV laboratory testing results. Based on laboratory testing, cases were either confirmed, possible, or unlikely ZIKV infection. Prenatal and postnatal imaging by ultrasound and/or magnetic resonance imaging (MRI) were categorized as normal, nonspecific, or as findings of congenital Zika syndrome (CZS). Of 81 women–fetus/infant pairs evaluated, 72 (89%) had confirmed ZIKV exposure; 18% of women were symptomatic; only a minority presented for evaluation within the time frame for laboratory detection. Zika virus could only be confirmed in 29 (40%) cases, was possible in 26 (36%) cases, and was excluded in 17 (24%) cases. Five cases (7%) had prenatal ultrasound and MRI findings of CZS, but in only three was ZIKV confirmed by laboratory testing. Because of timing of exposure to presentation, ZIKV infection could not be excluded in many cases. Neuroimaging found CZS in 7% of cases, and in many patients, there were nonspecific imaging findings that warrant long-term follow-up. Overall, adherence to postnatal recommended follow-up evaluations was modest, representing a barrier to care. These challenges may be instructive to future pediatric multidisciplinary clinics for congenital infectious/noninfectious threats to pregnant women and their infants.

scholarly journals ANALYSIS OF DETERMINANT FACTORS OF AFFECTING FAMILY ABILITY IN HIGH-RISK PREGNANCY

2021 ◽  
Vol 10 (1) ◽  
pp. 141-148
Author(s):  
Ika Mardiyanti ◽  
Yasi Anggasari
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Simple Random Sampling ◽  
Early Response ◽  
Significance Test ◽  
Questionnaire Data ◽  
Personal Factors ◽  
Cross Sectional ◽  
Determinant Factors ◽  
Risk Pregnancy

Background: The ability of pregnant women to deal with early response to high risks is still below the average, which is one of the causes of complications that can indicate the welfare of the mother and her fetus. Objectives: The aim of this study was to look at the determinants that influence early detection of high-risk pregnancies. Methods: This study used an analytic design with a cross sectional design. The sample size of 112 from a population of 155 was obtained by simple random sampling. The independent variables are individual factors, interpersonal influence, filial value and commitment, while the dependent variable is the family's ability to detect high risk of pregnancy for 3 months, namely August-October 2020 at PMB Ika Mardiyanti. This study uses a questionnaire. Data collection in the form of a questionnaire. Data analysis using SEM-PLS. Results: The results of the significance test concluded that all the path coefficients and the T statistical value of personal factors on interpersonal (0.453; 6.612), interpersonal on filial values ​​(0.753; 7.267), filial value for commitment (0.851; 17.048), filial value for ability (0.667 ; 4,679), commitment to ability (0.358; 2.356) is significant. Because all have a T-statistic value that is more than the T-table 1.96. Conclusion: The determinant factors that contribute to the ability of families to detect high risk of pregnancy need to be considered so that families are independent and have efforts to maintain the health of pregnant women in their families. In further research, it is necessary to involve other factors to improve family capacity, especially in the ability of families to detect high-risk pregnancies early.   Keywords: Ability, family, high-risk.

scholarly journals Vulnerability of high-risk pregnancy in the perception of pregnant women and their families

Rev Rene ◽  
2019 ◽  
Vol 20 ◽  
pp. e40207
Author(s):  
Viviane Cazetta de Lima Vieira ◽  
Mayckel da Silva Barreto ◽  
Verônica Francisqueti Marquete ◽  
Rebeca Rosa de Souza ◽  
Mayara Maria Johann Batista Fischer ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
High Risk Pregnancy ◽  
Risk Pregnancy

Gravidanza e diabete: una rassegna della letteratura

2009 ◽  
pp. 73-86
Author(s):  
Renata Tambelli ◽  
Manuela Errante
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Clinical Studies ◽  
Child Relationship ◽  
Risk Pregnancy ◽  
Mother Child Relationship

- In this review are discussed the main researches about high-risk pregnancy and, particularly, gestational diabetes mellitus (GDM). The results of these researches highlight that pregnant women with GDM are extremely vulnerable, anxious and worried. However there are not many clinical studies about the effect of GDM on the quality of mother-child relationship.

scholarly journals Zika Virus Serologic Diagnosis by NS1 ELISA in Curacao

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S302-S303 ◽  
Author(s):  
Samantha Manuel ◽  
Liane Virginia-Cova ◽  
Loubiela Joseph ◽  
Chris Roggeveen ◽  
Radjin Steingrover
Keyword(s):  
Zika Virus ◽  
Cross Reactivity ◽  
Pregnant Female ◽  
Serum Samples ◽  
Zikv Infection ◽  
Igm Elisa ◽  
Pcr Diagnosis ◽  
Two Samples ◽  
Negative Controls

Abstract Background Zika virus (ZIKV) was introduced in the Caribbean island of Curacao in January 2016. A commercially available ZIKV IgM and IgG ELISA was evaluated on patients that were PCR-positive for ZIKV. Methods ZIKV infection was established by PCR in urine samples. Samples from PCR-positive patients were selected for validation of a ZIKV NS1 IgG and IgM ELISA. Patients with a follow-up sample ≥ 2 weeks after initial presentation were used to assess the sensitivity of the assay. Samples of 15 historical controls with serological evidence of Dengue, Chikungunya or an unrelated viral infection were included to establish specificity and cross-reactivity. Results Fourteen patients with positive ZIKV PCR diagnosis had repeated serum samples drawn ≥ 2 weeks after the initial sample. The combined results of these repeated IgM and IgG tests resulted in a sensitivity of 92%. One pregnant female showed no presence of IgG or IgM in any of the two samples. Testing of the panel of historical ZIKV-negative controls resulted in a specificity of 100% in both the quantitative and semi-quantitative setting of the ELISA. One patient with known high-titers of antibodies against Chikungunya virus in the respective panel displayed borderline reactive results for ZIKV IgG in both quantitative and semi-quantitative setting of the assay. Conclusion In this PCR-positive ZIKV cohort of patients, the newly available ZIKV NS1 ELISA displayed excellent performance characteristics. Cross-reactivity was indicated for Chikungunya in one case. No cross-reactivity was found for Dengue virus infection. One pregnant female showed no signs of developing anti-ZIKV IgM or IgG in this study. In the light of intrauterine pathogenesis, the lack of development of maternal IgG during ZIKV infection is a concern. Disclosures All authors: No reported disclosures.

scholarly journals Atovaquone Inhibits Arbovirus Replication through the Depletion of Intracellular Nucleotides

2019 ◽  
Vol 93 (11) ◽  
Author(s):  
Angelica Cifuentes Kottkamp ◽  
Elfie De Jesus ◽  
Rebecca Grande ◽  
Julia A. Brown ◽  
Adam R. Jacobs ◽  
...  
Keyword(s):  
Viral Replication ◽  
Pregnant Women ◽  
Vulnerable Populations ◽  
Zika Virus ◽  
Ex Vivo ◽  
Pyrimidine Biosynthesis ◽  
Zikv Infection ◽  
Antiviral Therapies ◽  
Virion Production ◽  
Women And Children

ABSTRACT Arthropod-borne viruses represent a significant public health threat worldwide, yet there are few antiviral therapies or prophylaxes targeting these pathogens. In particular, the development of novel antivirals for high-risk populations such as pregnant women is essential to prevent devastating disease such as that which was experienced with the recent outbreak of Zika virus (ZIKV) in the Americas. One potential avenue to identify new and pregnancy-acceptable antiviral compounds is to repurpose well-known and widely used FDA-approved drugs. In this study, we addressed the antiviral role of atovaquone, an FDA Pregnancy Category C drug and pyrimidine biosynthesis inhibitor used for the prevention and treatment of parasitic infections. We found that atovaquone was able to inhibit ZIKV and chikungunya virus virion production in human cells and that this antiviral effect occurred early during infection at the initial steps of viral RNA replication. Moreover, we were able to complement viral replication and virion production with the addition of exogenous pyrimidine nucleosides, indicating that atovaquone functions through the inhibition of the pyrimidine biosynthesis pathway to inhibit viral replication. Finally, using an ex vivo human placental tissue model, we found that atovaquone could limit ZIKV infection in a dose-dependent manner, providing evidence that atovaquone may function as an antiviral in humans. Taken together, these studies suggest that atovaquone could be a broad-spectrum antiviral drug and a potential attractive candidate for the prophylaxis or treatment of arbovirus infection in vulnerable populations, such as pregnant women and children. IMPORTANCE The ability to protect vulnerable populations such as pregnant women and children from Zika virus and other arbovirus infections is essential to preventing the devastating complications induced by these viruses. One class of antiviral therapies may lie in known pregnancy-acceptable drugs that have the potential to mitigate arbovirus infections and disease, yet this has not been explored in detail. In this study, we show that the common antiparasitic drug atovaquone inhibits arbovirus replication through intracellular nucleotide depletion and can impair ZIKV infection in an ex vivo human placental explant model. Our study provides a novel function for atovaquone and highlights that the rediscovery of pregnancy-acceptable drugs with potential antiviral effects can be the key to better addressing the immediate need for treating viral infections and preventing potential birth complications and future disease.

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