Zika virus (ZIKV) infection during pregnancy appears to be associated with grave outcomes, including fetal death, placental insufficiency, fetal growth restriction, and central nervous system (CNS) injury, even with mild clinical symptoms. This according to a study of 88 women, 72 of whom tested positive for ZIKV in blood, urine, or both. Timing of acute ZIKV infection ranged from 5 to 38 weeks of gestation. Researchers found:

• Women who were positive for ZIKV were more likely than those who were negative for the virus to have maculopapular rash (44% vs 12%), conjunctival involvement (58% vs 13%), and lymphadenopathy (40% vs 7%).

• Fetal ultrasonography was performed in 42 ZIKV-positive women (58%) and in all ZIKV-negative women with fetal abnormalities detected in 12 of the 42 ZIKV-positive women (29%) and in none of the 16 ZIKA-negative women.

• Adverse findings included fetal deaths at 36 and 38 weeks of gestation (2 fetuses), in utero growth restriction with or without microcephaly (5 fetuses), ventricular calcifications or other CNS lesions (7 fetuses), and abnormal amniotic fluid volume or cerebral or umbilical artery flow (7 fetuses).

Citation: Brasil P, Pereira JP, Gabaglia CR, et al. Zika virus infection in pregnant women in Rio de Janeiro – preliminary report. [Published online ahead of print March 4, 2016]. N Engl J Med. doi:10.1056/NEJMoa1602412.