Outcomes of subsequent pregnancies following Zika virus infection: A comparative case series.

Melo, Adriana; Oliveira-Szejnfeld, Patrícia S; Malinger, Gustavo; Tavares, Jousilene S; Melo, Fabiana O; Coutinho, Larissa Cristina Q M; Gama, Gabriela L; Moll, Fernanda T; Aguiar, Renato S; Tanuri, Amílcar; Amorim, Melania M

OBJECTIVE To describe eight cases of women who became pregnant after a previous pregnancy that resulted in a fetus with congenital Zika syndrome (CZS). METHODS A prospective case series follow up study of all children of mothers that were pregnant with a fetus with CZS epidemics and delivered in a subsequent pregnancy. Head circumference at birth and abnormalities detected at neuroimaging were the primary outcomes. One- and five-minutes Apgar scores, gestational age at delivery, birth weight and birth length, laboratory diagnosis of ZIKV, the newborn condition at discharge and the neurological evaluation were secondary outcomes. RESULTS Eight mothers were included. Mean HC at birth was 31.3 ± 2.93 cm for the first child (with CZS) and 34.4 ± 1.48 cm for the second child (without CZS), p=0.02. Microcephaly was detected in 50% and neurological abnormalities in all the newborns after the first pregnancy; while there were no cases of microcephaly or neurological abnormalities in the infants resulting from the second pregnancy. CONCLUSIONS Despite the outcome of the cases evaluated suggest that most probably ZIKV does not persist as a chronic or latent, a large sample cohort is required to establish the safety of a subsequent pregnancy following ZIKV infection.