One in 10 pregnant women inside the continental United States using a confirmed Zika infection had a baby with brain damage or additional serious birth defects, according to the most comprehensive report to date on American pregnancies during the Zika crisis.
The report, published Tuesday by the Centers for Disease Control as well as Prevention, also provided more evidence in which the risk of birth defects was greater when women were infected inside the first trimester of pregnancy. Fifteen percent of women with confirmed Zika infection inside the first trimester had babies with birth defects, the report found.
“the idea’s an important report because the idea’s a more complete cohort today, so we’re getting a little more information,” said Dr. Roberta DeBiasi, chief of pediatric infectious diseases for the Children’s National Health System in Washington, who was not involved inside the study.
“the idea does answer in which the first trimester is actually the worst,” she said. “nevertheless you can’t take away by This particular, ‘Oh, as long as I’m not infected inside the first trimester, the idea will be fine.’”
The study indicates in which almost every state reported at least one woman using a suspected Zika infection in pregnancy. Some of the women were infected by mosquitoes inside the continental United States, nevertheless all 51 cases of birth defects reported inside the study were traced to infections acquired in one of 16 countries or territories in Latin America or the Caribbean, including Puerto Rico.
“The one thing in which didn’t exactly surprise me, nevertheless sobers me, is actually in which these reports come in by 44 states,” said Dr. Anne Schuchat, acting director of the C.D.C. “This particular isn’t something in which only the docs in Florida need to worry about; clinicians in every state need to know.”
The report found in which babies with birth defects were about as likely to be born to infected women who had no Zika symptoms as they were to women with symptoms, like rash or fever. In general, 80 percent of Zika infections do not produce symptoms.
nevertheless the report did not resolve the question of whether symptomatic infection in pregnancy is actually more dangerous to a fetus than asymptomatic infection, experts said. in which is actually because researchers may not have been aware of all the asymptomatic Zika cases: Some women without symptoms may not have gotten tested for Zika, as well as consequently, their cases might not be reported.
C.D.C. officials also pointed to another possible shortcoming inside the data: Despite a C.D.C. recommendation in which brain scans be performed on all babies born to women with possible Zika infection, only 25 percent of the babies inside the study had brain imaging, so the actual number of impaired infants could be higher.
“I think the idea is actually very likely in which we are underestimating the birth defects in which follow Zika in pregnancy,” Dr. Schuchat said. “Some babies in which are born looking pretty much O.K. are eventually diagnosed with some effects of congenital Zika syndrome.”
The report analyzed 1,297 pregnancies reported by Jan. 15 through Dec. 27, 2016, inside the 50 states as well as Washington, D.C. Of those, 972 with laboratory evidence of possible Zika infection were considered “completed,” resulting in 895 live births as well as 77 losses, a designation in which could include stillbirths, miscarriages as well as abortions.
Birth defects, ranging by the condition of abnormally modest heads, known as microcephaly, to neural tube defects as well as eye malformations, occurred in 5 percent, or 51, of those pregnancies, including 45 live births. Of the 250 cases where the presence of a Zika infection was confirmed with laboratory testing, 10 percent, or 24 pregnancies, resulted in birth defects, the report said.
All nevertheless eight of the 51 cases involved severe brain abnormalities such as microcephaly; the others had impairments in which included additional brain malformations as well as dysfunction inside the central nervous system. Fourteen of the pregnancies were traced to infection inside the first trimester, while 28 could have been infected during any trimester. The rest were missing information on the timing of infection.
Dr. Schuchat emphasized the report’s finding in which only “one out of four babies who was born had gotten the type of neuroimaging in which we recommend.”
Dr. DeBiasi said in which even when her hospital’s Zika program had detected probable infection in pregnant women as well as urged the hospitals where they planned to deliver to perform brain scans, in which had sometimes not occurred.
“Even if they look 100 percent beautiful at birth, they all need to get an ultrasound of the head,” Dr. DeBiasi said. Since only 25 percent of babies inside the report had brain scans, “the idea’s possible in which some of the additional 75 percent have problems, too.”
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