Approximately 14% of children who were born to mothers with confirmed or possible Zika virus infection during pregnancy in the US and its territories were identified during infancy or early childhood as having a Zika-associated birth defect, according to findings published in The Morbidity and Mortality Weekly Report.

Maternal exposure to Zika virus during pregnancy is associated with birth defects and possible neurodevelopmental abnormalities in offspring; early identification and management can improve cognitive, social, and behavioral functioning. The Centers for Disease Control and Prevention collaborated with state, territorial, and local health departments on the US Zika Pregnancy and Infant Registry (USZPIR) in monitoring pregnancy and infant and child outcomes among women with Zika exposure during pregnancy.

All pregnancies (n=4816) with confirmed or possible Zika virus infection and offspring (n=4199 live births) are included in the USZPIR. By February 1, 2018, a total of 2141 of those infants had attained 1 year of life. Within this group, a total of 1450 participants had some follow-up care reported to the USZPIR after age 14 days, and 203 of these (14%) had a Zika-associated birth defect, neurodevelopmental abnormality possibly associated with congenital Zika virus infection, or both. Among the 1386 (96%) children who did not appear to have microcephaly at birth, 822 (59%) received neuroimaging and 14 (2%) were identified with at least 1 brain anomaly. In addition, 494 (36%) children also underwent an ophthalmologic examination, and 12 (2%) had at least 1 ocular anomaly identified.

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“Because the full spectrum of adverse outcomes related to congenital Zika virus infection is not yet known, careful monitoring and evaluation of children born to mothers with laboratory evidence of confirmed or possible Zika virus infection during pregnancy is essential,” write the researchers, “For ensuring early detection of possible disabilities and early referral to intervention services that might improve outcomes.”

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Rice ME, Galang RR, Roth NM, et al. Vital Signs: Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection – U.S. Territories and Freely Associated States, 2018. MMWR Morb Mortal Wkly Rep. 2018; 67:858-867.