zika grossesse france

17 Jan zika grossesse france

), Centre Pluridisciplinaire de Diagnostic Prénatal (C.R. Pomar L, Malinger G, Benoist G, et al. virus Zika au cours de la grossesse Bruno Hoen, Anna L Funk, Benoit Tressières, Ingrid Vingadassalom, Eustase Janky, Philippe Kadhel, Catherine Ryan, Kinda Schepers, Stanie Gaete, Arnaud Fontanet PCR denotes polymerase chain reaction, and ZIKV Zika virus. The study was conducted in well-defined geographic areas, and high standards of care were available to all pregnant women living in these territories. The percentage of infants who were small for gestational age was similar in French territories in the Americas and in the Brazilian cohort (13.1% and 9%, respectively), but differences between those two cohorts are apparent when we examine the percentage of infants who were admitted to neonatal intensive care immediately after birth (1.3% in the French territories and 21% in Brazil) and the percentage of infants with abnormal neurologic findings from the clinical examination at birth (0.6% and 26.5%, respectively). § In the subcategories of TORCH, the denominators for the percent of women who tested positive are the numbers of women tested. ), Centre Hospitalier Universitaire (CHU) de Pointe-à-Pitre/Abymes, and Université des Antilles et de la Guyane, Faculté de Médecine Hyacinthe Bastaraud (B.H. Microcephaly was detected in 32 fetuses and infants (5.8%): 9 cases (1.6%) were severe, 9 (1.6%) were moderate-disproportionate, and 14 (2.5%) were moderate-proportionate. This study is part of the ZIKAlliance consortium project. 9. Thus, 561 women with symptomatic, PCR-confirmed, ZIKV infection were included in the analysis in this study. Ultrasound imaging for identification of cerebral damage in congenital Zika virus syndrome: a case series. The authors vouch for the completeness and accuracy of the data and analyses and for the fidelity of the study to the protocol. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Fetuses or infants may have had more than one neurologic or ocular defect. and Center for Global Health (A.F. Although the rate of complications would be expected to be higher among women with symptomatic infection than among those who were asymptomatic, an observational study involving U.S. women did not show any significant difference in the rate of birth defects between the offspring of women who had symptomatic ZIKV infection and the offspring of women who had asymptomatic ZIKV infection during pregnancy.5 A recent study also showed no significant association between disease severity or viral load and adverse outcomes.16 Second, we were not able to fully assess the presence of birth defects possibly associated with ZIKV infection in the case of the 11 miscarriages, 2 of the 6 stillbirths, and the 1 voluntary abortion, as well as in the 96 live-born infants (18.2% of the 527 live-born infants) who did not undergo prenatal ultrasonography after ZIKV infection. A key component of the ZIKA-DFA-FE study was the prospective follow-up, until the end of pregnancy, of women who had clinical symptoms of ZIKV infection during pregnancy. Stillbirth was defined as intrauterine fetal death that occurred at or after a gestational age of 20 weeks or intrapartum death during delivery. † Results from tests on urine specimens were negative or unknown, or tests were not performed. ‖ This infant had Down’s syndrome with severe microcephaly. JAMA Pediatr 2017;171:288-295. All karyotypes were normal except for one pericentric inversion of chromosome 2, and RT-PCR for ZIKV in an amniotic-fluid specimen was positive in 7 cases. If you are traveling outside of the continental United States, see Zika Travel Information to learn about your destination.. Concise summaries and expert physician commentary that busy clinicians need to enhance patient care. Information and tools for librarians about site license offerings. Neurologic and ocular abnormalities possibly associated with ZIKV infection were observed in 39 fetuses and infants (7.0%; 95% confidence interval [CI], 5.0 to 9.5): 28 live-born infants, 10 fetuses that were not carried to term because of termination of pregnancy for medical reasons, and 1 stillborn baby. La transmission par le lait maternel est exceptionnelle. Neurologic and ocular abnormalities were more common when ZIKV infection had occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it had occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001). It is therefore urgent to set up tools to collect clinical and paraclinical data for the evaluation of potential complications due to having ZIKV infection during pregnancy. ), Unit of Obstetrics and Gynecology, Maison de la Femme de la Mère et de l’Enfant (A.M., J.-L.V. Chez les patients infectés, le virus est retrouvé dans les urines, les larmes, les sécrétions vaginales, le lait maternel. Site de l'ECDC avec les dernières données : https://ecdc.europa.eu/en/zika-virus-infection. ), Pointe-à-Pitre, Guadeloupe; Centre Pluridisciplinaire de Diagnostic Prénatal, Maison de la Femme de la Mère et de l’Enfant (B.S. The study was performed in the French territories of Martinique, Guadeloupe, and French Guiana. Percentages may not total 100 because of rounding. Disclosure forms provided by the authors are available with the full text of this article at NEJM.org. For the purpose of comparison with other studies,5 miscarriage was defined as intrauterine fetal death that occurred before a gestational age of 20 weeks. Zika outbreaks have probably occurred in many locations. Also, the majority of missing ultrasonographic data involved pregnancies in which infection occurred during the third trimester, and the consequences of infection during the third trimester were found to be limited in the other infants of the same cohort. No travel history to Zika endemic countries was reported for the patient or partner. Arch Dis Child Educ Pract Ed 2013;98:93-98. Clinical information — including the number of previous pregnancies and live births, history of adverse pregnancy outcomes, pertinent medical history, body-mass index, symptoms of ZIKV infection, gestational age of fetuses, and any clinically relevant medical event during pregnancy — was recorded during this baseline visit, and blood and urine specimens were obtained. Passing the “TORCH.” Infect Dis Clin Pract 2008;16:4-5. Compte tenu de la gravité de latteinte du fœtus, les recommandations sadressent essentiellement aux femmes enceintes et aux couples qui ont un projet de grossesse. Microcephaly was considered moderate when the head circumference was between 3 SD and 2 SD below the mean and severe when the head circumference was more than 3 SD below the mean. In French Guiana, where the number of participants (24) was small, no birth defects possibly associated with ZIKV infection were observed. Le Zika peut également se manifester par une conjonctivite ou par une douleur derrièr… Virus Zika : toute l'actualité en direct, soyez informé de toute l'info en continu, en images et en vidéos. - Tang H et al :Cell Stel Cell 2016 18 ; 587-90, - Pomar L et al : Ultrasound Obstet Gynecol 2017 ; 6 ;729-36, Si vous êtes intéressés par notre association, si vous souhaitez nous aider ou nous proposer des projets, contactez nous à l'aide de la fiche ci-dessous, © 2023 by Mother & More. The analysis included all data collected up to April 27, 2017, the date of the last delivery in the cohort. First, the 2013–14 French Polynesian outbreak was the initial report of neurological and congenital complications in people infected by Zika virus, with an increase in incidence of Guillain-Barré syndrome and eight reported cases of neurological congenital malformations. The clinical implications of these findings in Brazil are not yet known and will be determined only through longer-term follow-up of infants. In the case of pregnancy loss or termination of pregnancy for medical reasons, autopsy measurements when available and findings from the last ultrasonographic examination were used to assess for microcephaly. L’OMS a ainsi décrit le syndrome congénital associé à l’infection ZIKV : disproportion crânio-faciale, spasticité, convulsions, irritabilité, troubles de l’alimentation, anomalies oculaires, malformations à l’imagerie. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. Severe microcephaly or other brain abnormalities included in the current definition of the congenital Zika syndrome were seen in 17 fetuses and infants (3.1%). 5. Table 1 shows the main characteristics of the 546 women (mean age, 29.7 years) with known pregnancy outcomes, and Table 2 shows the main characteristics of ZIKV infection in these women. 1. Vital signs: update on Zika virus–associated birth defects and evaluation of all U.S. infants with congenital Zika virus exposure — U.S. Zika Pregnancy Registry, 2016. ), CHU Martinique, Fort-de-France, Martinique; the Emerging Diseases Epidemiology Unit (A.L.F., Y.M., A.F.) Virus zika : recommandations pour les femmes enceintes Le virus zika présente un risque chez les femmes enceintes à cause de sa propagation épidémique. Dans une très grande majorité des cas, la maladie provoque peu de symptômes ou même l’absence de symptôme. ), Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne (B.H., K.S. Alerte au virus Zika en France : 2 cas signalés dans le Var. Pregnancy Outcomes after ZIKV Infection in French Territories in the Americas. Once women were enrolled, they underwent monthly clinical and ultrasonographic examinations until they had a pregnancy outcome. éruption maculo-papuleuse peu visible sur peau noire, autres : arthralgies, céphalées, asthénie, œdèmes, diarrhée…. The aim of this study was to estimate this risk among pregnant women with symptomatic ZIKV infection in French territories in the Americas. In conclusion, among pregnant women with PCR-confirmed, symptomatic ZIKV infection, birth defects possibly associated with ZIKV infection were present in 7% of fetuses and infants. Second, although birth defects could be observed as a consequence of ZIKV infection in any trimester of pregnancy, our data showed that the risk of birth defects and the risk of the congenital Zika syndrome were higher when ZIKV infection occurred early in pregnancy — a finding consistent with previous reports.5,15 The risk of birth defects was 12.7% when ZIKV infection occurred in the first trimester, 3.6% when it occurred in the second trimester, and 5.3% when it occurred in the third trimester, and the risk of the congenital Zika syndrome was 6.9%, 1.2%, and 0.9%, respectively. 13. de Jong EP, Vossen AC, Walther FJ, Lopriore E. How to use … neonatal TORCH testing. ¶ In the case of live birth, microcephaly was defined as a head circumference more than 2 SD below the mean, on the basis of INTERGROWTH-21st standards (http://intergrowth21.ndog.ox.ac.uk/) for sex and gestational age. Laboratory tests included RT-PCR for the detection of ZIKV (RealStar Zika Virus RT-PCR Kit 1.0, Altona Diagnostics) in blood, urine, or both at baseline in all women and at the end of pregnancy in the case of fetal death, termination of pregnancy, or stillbirth. Chez les nouveau-nés de mamans atteintes de la maladie, les malformations fœtales retrouvées durant les dernières années comptent notamment parmi elles la microcéphalie . There is currently no vaccine for preventing Zika virus infection and no specific medication for treating the disease. In 3 of the 527 live births (0.6%), clinical abnormalities other than microcephaly were detected at birth. The analysis included all data collected up to April 27, 2017, the date of the last delivery in the cohort. Halai UA, Nielsen-Saines K, Moreira ML, et al. From INSERM Centre d’Investigation Clinique 1424 (B.H., C.C., B.T. All participants provided written informed consent. N Engl J Med 2017;377:1399-1400. Case Records of the Massachusetts General Hospital, Injuries from Less-Lethal Weapons during the George Floyd Protests in Minneapolis, Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19, (A Little) Clarity on Convalescent Plasma for Covid-19, CMS Innovation Center at 10 Years — Progress and Lessons Learned, Interim Results of a Phase 1–2a Trial of Ad26.COV2.S Covid-19 Vaccine. During the enrollment visit, sociodemographic data were collected for each woman. Although missing ultrasonographic data may have led to underdiagnosis of ZIKV-related birth defects, it should be noted that in our cohort, only 1 live-born baby had an isolated brain abnormality (ventriculomegaly), detected by MRI, in the absence of clinical abnormalities, after infection during the second trimester of pregnancy. Zika et grossesse : un risque de malformation fœtale ... En France, celle-ci devrait être acceptée sans problème si le retard mental est avéré au vu des anomalies constatées à l’échographie. le 23 octobre 2019 à 16h17 Rechercher. 17. » Que faire pendant la grossesse ? Tolan RJ. Data on BMI are missing for 90 women (16.5%). ), Paris; CIRE de Guyane, Santé Publique France (V.A. Honein MA, Dawson AL, Petersen EE, et al. 11. The same was true for severe microcephaly (3.7%, 0.8%, and 0.0%, respectively; P=0.02) and the congenital Zika syndrome (6.9%, 1.2%, and 0.9%, respectively; P=0.002). MMWR Morb Mortal Wkly Rep 2017;66:615-621. ), and Pôle Parent-Enfant (E.J. Declaration of Zika virus infection is now mandatory in France. If a fetal abnormality was identified during a follow-up ultrasonographic examination, magnetic resonance imaging (MRI) of the fetus was performed, and the woman was followed up monthly with laboratory testing and ultrasonography, as reported elsewhere.9-11 The end point for each woman enrolled in the study was the pregnancy outcome: delivery of a live-born infant with or without birth defects, miscarriage, termination of pregnancy for medical reasons, or stillbirth. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT02916732. A total of 28 fetuses (5.0%) were not carried to term or were stillborn; there were 11 miscarriages, 10 terminations of pregnancy for medical reasons, 6 stillbirths, and 1 voluntary abortion. Address reprint requests to Dr. Hoen at the Department of Infectious Diseases, Dermatology, and Internal Medicine, University Medical Center of Guadeloupe, BP 465, 97159 Pointe-à-Pitre, CEDEX, France, or at [email protected].

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