Why Did ZIKV Perinatal Outcomes Differ in Distinct Regions of Brazil? An Exploratory Study of Two Cohorts

Damasceno, Luana; Terzian, Ana Carolina B.; Fuller, Trevon; Estofolete, Cassia F.; Andrade, Adriana; Kroon, Erna G.; Zin, Andrea A.; Vasconcelos, Zilton; Pereira, Jose P.; Castilho, Márcia C.; Piaulino, Isa Cristina R.; Vasilakis, Nikos; Moreira, Maria E.; Nielsen-Saines, Karin; Espinosa, Flor E. Martinez; Nogueira, Maurício L.; Brasil, Patricia

doi:10.3390/v13050736

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Why Did ZIKV Perinatal Outcomes Differ in Distinct Regions of Brazil? An Exploratory Study of Two Cohorts

Luana Damasceno

^1,†,

Ana Carolina B. Terzian

^2,†

⁴,

⁴

⁵,

⁵

⁵,

⁶,

Isa Cristina R. Piaulino

⁷,

Nikos Vasilakis

⁸

Maria E. Moreira

⁵

Karin Nielsen-Saines

⁹,

Flor E. Martinez Espinosa

^10,11,

Maurício L. Nogueira

^3,*,‡

and

Patricia Brasil

^1,*,‡

Acute Febrile Illnesses Laboratory, National Institute of Infectious Diseases, Oswaldo Cruz Foundation (OCRUZ), Rio de Janeiro, RJ 21040-900, Brazil

René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ/Minas), Belo Horizonte, MG 30190-002, Brazil

Laboratory of Virology, School of Medicine (FAMERP), São José do Rio Preto, SP 15090-000, Brazil

⁴

Institute of Biological Sciences, Federal University of Minas Gerais (UFMG), Pampulha-Belo Horizonte, MG 31270-901, Brazil

⁵

Fernandes Figueira Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ 22250-020, Brazil

⁶

Department of Virology, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM 69040-000, Brazil

⁷

Postgraduate Program in Tropical Medicine, Amazonas State University, Manaus, AM 69040-000, Brazil

⁸

Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA

⁹

Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA

¹⁰

Laboratory of Territory, Environment, Health, and Sustainability, Leônidas & Maria Deane Institute, Oswaldo Cruz Foundation (FIOCRUZ/Amazonia), Manaus, AM 69057-070, Brazil

¹¹

Department of Malaria, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM 69040-000, Brazil

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^†

These authors contributed to this work equally.

^‡

These authors contributed to this work equally.

Academic Editor: Luis Martinez-Sobrido

Viruses 2021, 13(5), 736; https://doi.org/10.3390/v13050736

Received: 5 March 2021 / Revised: 5 April 2021 / Accepted: 7 April 2021 / Published: 23 April 2021

(This article belongs to the Special Issue Zika Virus Infections in Pregnancy and Congenital Zika Syndrome in the Latin American Region)

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Abstract

The Zika virus (ZIKV) epidemic in Brazil occurred in regions where dengue viruses (DENV) are historically endemic. We investigated the differences in adverse pregnancy/infant outcomes in two cohorts comprising 114 pregnant women with PCR-confirmed ZIKV infection in Rio de Janeiro, Southeastern Brazil (n = 50) and Manaus, in the north region of the country (n = 64). Prior exposure to DENV was evaluated through plaque reduction neutralizing antibody assays (PRNT 80) and DENV IgG serologies. Potential associations between pregnancy outcomes and Zika attack rates in the two cities were explored. Overall, 31 women (27%) had adverse pregnancy/infant outcomes, 27 in Rio (54%) and 4 in Manaus (6%), p < 0.001. This included 4 pregnancy losses (13%) and 27 infants with abnormalities at birth (24%). A total of 93 women (82%) had evidence of prior DENV exposure, 45 in Rio (90%) and 48 in Manaus (75%). Zika attack rates differed; the rate in Rio was 10.28 cases/10,000 and in Manaus, 0.6 cases/10,000, p < 0.001. Only Zika attack rates (Odds Ratio: 17.6, 95% Confidence Interval 5.6–55.9, p < 0.001) and infection in the first trimester of pregnancy (OR: 4.26, 95% CI 1.4–12.9, p = 0.011) were associated with adverse pregnancy and infant outcomes. Pre-existing immunity to DENV was not associated with outcomes (normal or abnormal) in patients with ZIKV infection during pregnancy. View Full-Text

Keywords: Zika; pregnancy; obstetrics; arboviruses; dengue

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MDPI and ACS Style

Damasceno, L.; Terzian, A.C.B.; Fuller, T.; Estofolete, C.F.; Andrade, A.; Kroon, E.G.; Zin, A.A.; Vasconcelos, Z.; Pereira, J.P., Jr.; Castilho, M.C.; Piaulino, I.C.R.; Vasilakis, N.; Moreira, M.E.; Nielsen-Saines, K.; Espinosa, F.E.M.; Nogueira, M.L.; Brasil, P. Why Did ZIKV Perinatal Outcomes Differ in Distinct Regions of Brazil? An Exploratory Study of Two Cohorts. Viruses 2021, 13, 736. https://doi.org/10.3390/v13050736

AMA Style

Damasceno L, Terzian ACB, Fuller T, Estofolete CF, Andrade A, Kroon EG, Zin AA, Vasconcelos Z, Pereira JP Jr., Castilho MC, Piaulino ICR, Vasilakis N, Moreira ME, Nielsen-Saines K, Espinosa FEM, Nogueira ML, Brasil P. Why Did ZIKV Perinatal Outcomes Differ in Distinct Regions of Brazil? An Exploratory Study of Two Cohorts. Viruses. 2021; 13(5):736. https://doi.org/10.3390/v13050736

Chicago/Turabian Style

Damasceno, Luana, Ana C.B. Terzian, Trevon Fuller, Cassia F. Estofolete, Adriana Andrade, Erna G. Kroon, Andrea A. Zin, Zilton Vasconcelos, Jose P. Pereira Jr., Márcia C. Castilho, Isa C.R. Piaulino, Nikos Vasilakis, Maria E. Moreira, Karin Nielsen-Saines, Flor E.M. Espinosa, Maurício L. Nogueira, and Patricia Brasil. 2021. "Why Did ZIKV Perinatal Outcomes Differ in Distinct Regions of Brazil? An Exploratory Study of Two Cohorts" Viruses 13, no. 5: 736. https://doi.org/10.3390/v13050736

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