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August 24, 2018: Children Exposed to Zika in Utero Need Long-term Monitoring

About one in seven children age 1 or older who were born to women with Zika virus infection during pregnancy have one or more health problems possibly caused by in utero exposure to the virus.

That’s according to a CDC Morbidity and Mortality Weekly Report (MMWR)( and related Vital Signs( report released Aug. 10.

“We know that Zika virus infection during pregnancy can cause serious health problems in babies, such as birth defects and vision problems, including conditions not always evident at birth,” said CDC Director Robert Redfield, M.D., in a news release “We are still learning about the full range of long-term health problems these babies could face. We thank clinicians for their continued commitment to conduct all necessary tests and evaluations to ensure appropriate care.”

More than 4,800 pregnancies from U.S. territories and freely associated states that had laboratory results showing possible or confirmed Zika virus infection were reported to the U.S. Zika Pregnancy and Infant Registry (USZPIR) from 2016-2018.

Of these cases, 1,450 infants who reached age 1 or more by Feb. 1, 2018, had some follow-up care reported to the USZPIR after their first 14 days of life. Among these children, 95 percent had at least one physical exam at that point, 76 percent had developmental screening or evaluation, 60 percent had postnatal neuroimaging, and 48 percent had automated auditory brainstem response-based hearing screen or evaluation. Ophthalmic examination was reported in 36 percent of the children.

Among all the children with reported follow-up care, 6 percent had at least one Zika-associated birth defect identified, 9 percent had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection identified, and 1 percent had both. Overall, about one in seven children had health problems possibly caused by Zika reported.

The CDC recommends that all infants born to mothers with Zika virus infection during pregnancy receive a variety of screenings and care even if they appear healthy at birth. This includes providing recommended pediatric follow-up care and referrals,( including early intervention services.

The researchers noted that many of the children assessed didn’t receive all recommended screening for health problems potentially related to Zika virus. Following the recommended screenings and care for these babies is important, the CDC stated, to help ensure early identification of health problems and timely referral to services.

The agency also offered reminders that family physicians can use during visits with mothers and their children, including:

Ask every mother about possible Zika exposure during pregnancy, even if her baby appears healthy;
Share Zika test results with all health care professionals working with both mother and baby; and
Report health information about babies and young children affected by Zika during pregnancy to their state, local or territorial health department, even if they appear healthy.

Although there have been fewer cases of infection in the past couple of years, Zika virus still poses a risk for pregnant women and their infants, said CDC officials.

In addition to the 4,800 pregnancies in the U.S. territories and freely associated states described earlier, the CDC said nearly 2,500 pregnancies in the United States had laboratory results showing possible or confirmed Zika virus infection.

Source: AAFP News

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