The Zika virus and pregnancy: evidence, management, and prevention

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 30; no. 4; pp. 386 - 396
• Main Authors: Citil Dogan, Ayse, Wayne, Sandra, Bauer, Samuel, Ogunyemi, Dotun, Kulkharni, Santosh K., Maulik, Devika, Carpenter, Christopher F., Bahado-Singh, Ray O.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 16-02-2017
• Subjects: Aedes; Animals; Female; Fetal Development; Guidelines as Topic; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Insect Bites and Stings - prevention & control; Male; Management of Zika virus; Microcephaly - prevention & control; Pregnancy; Pregnancy Complications, Infectious - prevention & control; Pregnancy Complications, Infectious - virology; Travel; Zika Virus; Zika virus infection; Zika Virus Infection - complications; Zika Virus Infection - diagnosis; Zika Virus Infection - prevention & control; Zika Virus Infection - transmission; Zika virus infection; Management of Zika virus; pregnancy
• ISSN: 1476-7058; 1476-4954
• DOI: 10.3109/14767058.2016.1174210

Objective: To comprehensively review the available evidence and existing consensus reports and guidelines regarding the pregnancy and reproductive implications of the mosquito-transmitted Zika virus (ZIKV) infection. A primary focus was to provide pertinent information to aid clinicians in the management of pregnancies at risk for, exposed to, or with confirmed ZIKV infection.
Method: An extensive literature review was performed using Pubmed. Practice guidelines and consensus reports were accessed from international, national, and professional organizations' websites. The clinical articles for ZIKV infection testing varied from case reports to small epidemiologic studies.
Results: A ZIKV epidemic has been declared in several countries in the Americas. Fifty-two travel-associated ZIKV infection cases have been reported throughout the USA (as of February 10, 2016). The consequences of congenital fetal/newborn ZIKV infection could potentially have devastating consequences including miscarriage, fetal death, and major anomalies such as microcephaly, brain and brain-stem defects, and long-term neurologic sequelae. While not definitive, current evidence suggests the existence of nonvector-borne transmission through sexual activity with an infected male partner. For women at risk for sexual transmission, condom use is advised, especially during pregnancy.
Conclusion: While ZIKV infection appears to be a mild disease in the general population the potential consequences to the fetus and newborn could be profound. Management guidelines are currently evolving and will be significantly impacted as new evidence develops. It is therefore imperative that obstetric health-care providers keep abreast of this rapidly evolving information landscape that has so far characterized this outbreak.