Pregnancy outcomes after maternal Zika virus infection in a non-endemic region: prospective cohort study

C. Rodó, A. Suy, E. Sulleiro, A. Soriano-Arandes, N. Maiz, I. García-Ruiz, S. Arévalo, A. Rando, A. Anton, Vázquez Méndez, M. Garrido, A. Frick, C. Rodrigo, T. Pumarola, E. Carreras

Research output: Contribution to journalArticleResearch

11 Citations (Scopus)


© 2019 European Society of Clinical Microbiology and Infectious Diseases Objectives: The aim was to describe pregnancy outcomes after Zika virus (ZIKV) infection in a non-endemic region. Methods: According to the Spanish protocol issued after the ZIKV outbreak in Brazil in 2015, all pregnant women who had travelled to high-burden countries were screened for ZIKV. Serological and molecular tests were used to identify ZIKV-infected pregnant women. They were classified as confirmed ZIKV infection when reverse transcription (RT) PCR tested positive, or probable ZIKV infection when ZIKV immunoglobulin M and/or immunoglobulin G and ZIKV plaque reduction neutralization tests were positive. Women found positive using molecular or serological tests were prospectively followed-up with ultrasound scans and neurosonograms on a monthly basis until delivery; magnetic resonance imaging and amniotic fluid testing were performed after signed informed consent. Samples of placenta, and fetal and neonatal tissues were obtained. Results: Seventy-two pregnant women tested positive for ZIKV infection: ten were confirmed by RT-PCR, and 62 were probable cases based on serological tests. The prevalence of adverse perinatal outcomes was 33.3% (three out of nine, 95% CI 12.1–64.6%): two cases of congenital ZIKV syndrome (CZS) and one miscarriage, all born to women infected in the first trimester of gestation. All ZIKV-confirmed women had persistent viraemias beyond 2 weeks (median 61.50 days; IQR 35.50–80.75). Amniotic fluid testing was only positive in the two fetuses with anomalies. Conclusion: The prevalence of perinatal adverse outcomes for women with ZIKV-confirmed infection was 33.3%. Amniocentesis for ZIKV RT-PCR is recommended when fetal abnormalities are found. Intensive prenatal and postnatal follow-up of ZIKV-infected pregnancies is advised in confirmed cases.
Original languageEnglish
Pages (from-to)633.e5-633.e9
JournalClinical Microbiology and Infection
Publication statusPublished - 1 May 2019


  • Amniotic fluid
  • brain malformation
  • congenital
  • prenatal diagnosis
  • ultrasound
  • Zika virus

Fingerprint Dive into the research topics of 'Pregnancy outcomes after maternal Zika virus infection in a non-endemic region: prospective cohort study'. Together they form a unique fingerprint.

Cite this