Reassessment of the risk of birth defects due to Zika virus in Guadeloupe, 2016

PLoS Negl Trop Dis. 2021 Mar 3;15(3):e0009048. doi: 10.1371/journal.pntd.0009048. eCollection 2021 Mar.

Abstract

Background: In the French Territories in the Americas (FTA), the risk of birth defects possibly associated with Zika virus (ZIKV) infection was 7.0% (95%CI: 5.0 to 9.5) among foetuses/infants of 546 women with symptomatic RT-PCR confirmed ZIKV infection during pregnancy. Many of these defects were isolated measurement-based microcephaly (i.e. without any detected brain or clinical abnormalities) or mild neurological conditions. We wanted to estimate the proportion of such minor findings among live births of women who were pregnant in the same region during the outbreak period but who were not infected with ZIKV.

Methods: In Guadeloupe, pregnant women were recruited at the time of delivery and tested for ZIKV infection. The outcomes of live born infants of ZIKV non-infected women were compared to those of ZIKV-exposed live born infants in Guadeloupe, extracted from the FTA prospective cohort.

Results: Of 490 live born infants without exposure to ZIKV, 42 infants (8.6%, 95%CI: 6.2-11.4) had mild abnormalities that have been described as 'potentially linked to ZIKV infection'; all but one of these was isolated measurement-based microcephaly. Among the 241 live born infants with ZIKV exposure, the proportion of such abnormalities, using the same definition, was similar (6.6%, 95%CI: 3.8-10.6).

Conclusions: Isolated anthropometric abnormalities and mild neurological conditions were as prevalent among infants with and without in-utero ZIKV exposure. If such abnormalities had not been considered as 'potentially linked to ZIKV' in the original prospective cohort in Guadeloupe, the overall estimate of the risk of birth defects considered due to the virus would have been significantly lower, at approximately 1.6% (95% CI: 0.4-4.1).

Trial registration: ClinicalTrials.gov (NCT02916732).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Congenital Abnormalities / epidemiology*
  • Female
  • Guadeloupe / epidemiology
  • Humans
  • Infant, Newborn
  • Microcephaly / epidemiology*
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Prospective Studies
  • Zika Virus / isolation & purification
  • Zika Virus Infection / complications*

Associated data

  • ClinicalTrials.gov/NCT02916732

Grants and funding

This work was supported by the French Ministry of Health (Soutien Exceptionnel à la Recherche et à l’Innovation) which was received by BH, Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases project (ANR-10-LABEX-62-IBEID) which was received by AF, the European Union’s Horizon 2020 Research and Innovation Program through the ZikAlliance consortium (Grant Agreement no. 73458) which was received by BH, and by INSERM which was received by BH. ALF was part of the Pasteur – Paris University (PPU) International PhD Program until late 2018, from which she received funding from the Institut Carnot Pasteur Maladie Infectieuse (ANR 11-CARN 017-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.