MedicalResearch.com Interview with:
Karin Nielsen, MD, MPH
Professor of Clinical Pediatrics
Division of Pediatric Infectious Diseases
David Geffen School of Medicine at UCLA
Director, Center for Brazilian Studies
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our research was a prospective study in which pregnant women in Rio de Janeiro who developed a rash in the last 5 days between the end of 2015 to mid 2016 were screened for possible infection with Zika virus by a special molecular test (PCR) which looked for the virus in blood or urine. Women who were found to have Zika virus in either blood, urine or both were followed throughout time to look for pregnancy and infant outcomes. We also followed women who had a negative PCR test for Zika as a comparison group. By July 2016, we had outcomes known for 125 Zika affected pregnancies, of these 58 had abnormal outcomes, with 9 fetal losses and 49 babies who had abnormal findings on physical exam or brain imaging, all consistent with neurologic abnormalities. This meant 46% of the pregnant women in our study had an abnormal pregnancy outcome, and 42% of live birth infants were found to have an abnormality in the first few months of life.
MedicalResearch.com: What should readers take away from your report?
Response: Our main finding is that Zika virus is extremely deleterious to the fetus and responsible for abnormal pregnancy findings in nearly 50% of cases. As we knew the time of acute infection in the mothers, we were able to find out how this correlated with the timing of transmission and found that Zika virus caused abnormal pregnancy outcomes in 55% of women infected in the first trimester, 52% of women infected in the second trimester, and 29% of women infected in the last trimester of pregnancy.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Infants with suspicion of Zika virus infection should be followed prospectively in the first years of life as potentially some of the damage caused by this virus might not be immediately apparent at birth. There are still many questions to be answered in order to understand the pathogenesis of transmission of this virus from mother to fetus.
MedicalResearch.com: Is there anything else you would like to add?
Response: I’ve added our press release on the topic, would also recommend looking at the Quick Take video the NEJM has for this manuscript online.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Zika Virus Infection in Pregnant Women in Rio de Janeiro
Patrícia Brasil, M.D., Ph.D., José P. Pereira, Jr., M.D., M. Elisabeth Moreira, M.D., Ph.D., Rita M. Ribeiro Nogueira, M.D., Ph.D., Luana Damasceno, Pharm.D., Mayumi Wakimoto, M.D., Ph.D., Renata S. Rabello, D.V.M., Ph.D., Stephanie G. Valderramos, M.D., Ph.D., Umme-Aiman Halai, M.D., Tania S. Salles, M.D., Ph.D., Andrea A. Zin, M.D., Ph.D., Dafne Horovitz, M.D., Ph.D., Pedro Daltro, M.D., Ph.D., Marcia Boechat, M.D., Ph.D., Claudia Raja Gabaglia, M.D., Ph.D., Patrícia Carvalho de Sequeira, Ph.D., José H. Pilotto, M.D., Ph.D., Raquel Medialdea-Carrera, Ph.D., Denise Cotrim da Cunha, M.D., Liege M. Abreu de Carvalho, M.D., Marcos Pone, M.D., André Machado Siqueira, M.D., Ph.D., Guilherme A. Calvet, M.D., Ph.D., Ana E. Rodrigues Baião, M.D., Elizabeth S. Neves, M.D., Ph.D., Paulo R. Nassar de Carvalho, M.D., Renata H. Hasue, Ph.D., Peter B. Marschik, Ph.D., Christa Einspieler, Ph.D., Carla Janzen, M.D., Ph.D., James D. Cherry, M.D., Ana M. Bispo de Filippis, Ph.D., and Karin Nielsen-Saines, M.D.
N Engl J Med 2016; 375:2321-2334
December 15, 2016DOI: 10.1056/NEJMoa1602412
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