Background Zika virus is a teratogenic agent with predominant tropism for the fetal brain. The real incidence of fetal infection and affection is unknown, and severe disease has been demonstrated throughout pregnancy. Methods Since the Zika virus outbreak in Brazil in November 2015 all pregnant women with epidemiological link to an endemic area were prospectively screened for Zika virus in Catalonia, Spain. According to the Spanish protocol, serological and biological tests were used to identify infected pregnant women. They were followed-up in a monthly basis with ultrasound scans and neurosonograms; magnetic resonance and amniotic fluid testing were performed after signed informed consent. Samples of placenta and fetal and neonatal tissues were also obtained. Results Seventy-two pregnant women tested positive for Zika virus infection; ten were confirmed cases and 62 were probable cases. The overall rate of adverse perinatal outcome in women with confirmed Zika virus infection and complete follow-up was 33% (95%CI, 12.1-64.6%). Two cases of Zika virus congenital syndrome and one miscarriage, all of them born to women with confirmed infection in the first trimester. 25% of women reported symptoms during pregnancy, mostly rash and fever. All women with confirmed infection had persistent viremias beyond the expected time (median 61.50 days (IQR 35.50-80.75)). Conclusion The overall adverse outcome rate in women with confirmed Zika virus infection is 33%. First trimester infections of Zika virus are associated with worse outcomes in a non-endemic country.
- Zika virus
- Congenital malformation