Zika virus infection in pregnancy: a systematic review of disease course and complications

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Further research and comprehensive reporting of maternal ZIKV infection and fetal/neonatal complications can provide more effective and evidence-based strategies, guidelines, recommendations and health policies aimed at the management of maternal ZIKV infection. Nonetheless, adherence to current best practices guidelines for prenatal care among health providers is encouraged.

In humans Zika Virus (ZIKV) infection is mild to asymptomatic with pregnant women are at exceptional risk of being infected and exhibiting potential adverse effects. Currently, many gaps in the knowledge regarding ZIKV infection exist. A systematic review was conducted to characterize maternal Zika virus (ZIKV) infection and complement the evidence base for the WHO interim guidance on pregnancy management in the context of ZIKV infection. Among 142 eligible articles, 18 met the inclusion criteria (13 case series/reports and five cohort studies). No study suggested a higher risk of acquiring ZIKV infection in pregnant women compared to the non-pregnant population. Common symptoms among pregnant women with suspected/confirmed ZIKV infection were fever, rash, and arthralgia. Regarding fetuses and newborns, one case of Guillain-Barré syndrome was reported among infected mothers. A range of fetal and newborn neurological and ocular abnormalities were reported but microcephaly was the primary neurological complication. There was a lack of information on co-infection with other flaviviruses and common congenital infections. Serological tests in 11 studies were conducted to assess for the presence of other coinfections and 4 assessed previous exposure to other infections.

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