1
|
Reeves EL, Neelam V, Carlson JM, Olsen EO, Fox CJ, Woodworth KR, Nestoridi E, Mobley E, Montero Castro S, Dzimira P, Sokale A, Sizemore L, Hall AJ, Ellington S, Cohn A, Gilboa SM, Tong VT. Pregnancy and infant outcomes following SARS-CoV-2 infection in pregnancy during delta variant predominance - Surveillance for Emerging Threats to Pregnant People and Infants. Am J Obstet Gynecol MFM 2024; 6:101265. [PMID: 38135220 DOI: 10.1016/j.ajogmf.2023.101265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND SARS-CoV-2 infection in pregnancy is associated with an increased risk of adverse birth outcomes such as preterm birth, stillbirth, and maternal and infant complications. Previous research suggests an increased risk of severe COVID-19 illness and stillbirth in pregnant people during delta variant predominance in 2021; however, those studies did not assess timing of infection during pregnancy, and few of them described COVID-19 vaccination status. OBJECTIVE Using a large population-based cohort, this study compared pregnancy and infant outcomes and described demographic and clinical characteristics of pregnant people with SARS-CoV-2 infection prior to and during the delta variant period. STUDY DESIGN This retrospective cohort analysis included persons with confirmed SARS-CoV-2 infection in pregnancy from 6 US jurisdictions reporting to the Surveillance for Emerging Threats to Pregnant People and Infants Network. Data were collected through case reports of polymerase chain reaction-positive pregnant persons and linkages to birth certificates, fetal death records, and immunization records. We described clinical characteristics and compared frequency of spontaneous abortion (<20 weeks of gestation), stillbirth (≥20 weeks), preterm birth (<37 weeks), small for gestational age, and term infant neonatal intensive care unit admission between the time periods of pre-delta and delta variant predominance. Study time periods were determined by when variants constituted more than 50% of sequences isolated according to regional SARS-CoV-2 genomic surveillance data, with time periods defined for pre-delta (March 3, 2020-June 25, 2021) and Delta (June 26, 2021-December 25, 2021). Adjusted prevalence ratios were estimated for each outcome measure using Poisson regression and were adjusted for continuous maternal age, race and ethnicity, and insurance status at delivery. RESULTS Among 57,563 pregnancy outcomes, 57,188 (99.3%) were liveborn infants, 65 (0.1%) were spontaneous abortions, and 310 (0.5%) were stillbirths. Most pregnant persons were unvaccinated at the time of SARS-CoV-2 infection, with a higher proportion in pre-delta (99.4%) than in the delta period (78.4%). Of those with infections during delta and who were previously vaccinated, the timing from last vaccination to infection was a median of 183 days. Compared to pre-delta, infections during delta were associated with a higher frequency of stillbirths (0.7% vs 0.4%; adjusted prevalence ratio, 1.55; 95% confidence interval, 1.14-2.09) and preterm births (12.8% vs 11.9%; adjusted prevalence ratio, 1.14; 95% confidence interval, 1.07-1.20). The delta period was associated with a lower frequency of neonatal intensive care unit admission (adjusted prevalence ratio, 0.74; 95% confidence interval, 0.67-0.82) than in the pre-delta period. During the delta period, infection during the third trimester was associated with a higher frequency of preterm birth (adjusted prevalence ratio, 1.41; 95% confidence interval, 1.28-1.56) and neonatal intensive care unit admission (adjusted prevalence ratio, 1.21; 95% confidence interval, 1.01-1.45) compared to the first and second trimester combined. CONCLUSION In this US-based cohort of persons with SARS-CoV-2 infection in pregnancy, the majority were unvaccinated, and frequencies of stillbirth and preterm birth were higher during the delta variant predominance period than in the pre-delta period. During the delta period, frequency of preterm birth and neonatal intensive care unit admission was higher among infections occurring in the third trimester vs those earlier in pregnancy. These findings demonstrate population-level increases of adverse fetal and infant outcomes, specifically in the presence of a COVID-19 variant with more severe presentation.
Collapse
Affiliation(s)
- Emily L Reeves
- Eagle Global Scientific, LLC, Atlanta, GA (Ms Reeves, Dr Carlson, and Ms Fox).
| | - Varsha Neelam
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)
| | - Jeffrey M Carlson
- Eagle Global Scientific, LLC, Atlanta, GA (Ms Reeves, Dr Carlson, and Ms Fox)
| | - Emily O Olsen
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)
| | - Charise J Fox
- Eagle Global Scientific, LLC, Atlanta, GA (Ms Reeves, Dr Carlson, and Ms Fox)
| | - Kate R Woodworth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)
| | - Eirini Nestoridi
- Massachusetts Department of Public Health, Boston, MA (Dr Nestoridi)
| | - Evan Mobley
- Missouri Department of Health and Senior Services, Jefferson City, MO (Mr Mobley)
| | | | - Paula Dzimira
- Pennsylvania Department of Health, Pittsburgh, PA (Ms Dzimira)
| | - Ayomide Sokale
- Philadelphia Department of Public Health, Philadelphia, PA (Ms Sokale)
| | | | - Aron J Hall
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (Dr Hall)
| | - Sascha Ellington
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (Dr Ellington)
| | - Amanda Cohn
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)
| | - Suzanne M Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)
| | - Van T Tong
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA (Ms Neelam; Drs Olsen, Woodworth, Cohn, and Gilboa; and Ms Tong)
| |
Collapse
|
2
|
Neelam V, Woodworth KR, Chang DJ, Roth NM, Reynolds MR, Akosa A, Carr CP, Anderson KN, Mulkey SB, DeBiasi RL, Biddle C, Lee EH, Elmore AL, Scotland SJ, Sowunmi S, Longcore ND, Ahmed M, Langlois PH, Khuwaja S, Browne SE, Lind L, Shim K, Gosciminski M, Blumenfeld R, Khuntia S, Halai UA, Locklear A, Chan M, Willabus T, Tonzel J, Marzec NS, Barreto NA, Sanchez C, Fornoff J, Hale S, Nance A, Iguchi L, Adibhatla SN, Potts E, Schiffman E, Raman D, McDonald MF, Stricklin B, Ludwig E, Denson L, Contreras D, Romitti PA, Ferrell E, Marx M, Signs K, Cook A, Leedom VO, Beauregard S, Orantes LC, Cronquist L, Roush L, Godfred-Cato S, Gilboa SM, Meaney-Delman D, Honein MA, Moore CA, Tong VT. Outcomes up to age 36 months after congenital Zika virus infection-U.S. states. Pediatr Res 2024; 95:558-565. [PMID: 37658124 PMCID: PMC10913023 DOI: 10.1038/s41390-023-02787-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/24/2023] [Accepted: 06/15/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND To characterize neurodevelopmental abnormalities in children up to 36 months of age with congenital Zika virus exposure. METHODS From the U.S. Zika Pregnancy and Infant Registry, a national surveillance system to monitor pregnancies with laboratory evidence of Zika virus infection, pregnancy outcomes and presence of Zika associated birth defects (ZBD) were reported among infants with available information. Neurologic sequelae and developmental delay were reported among children with ≥1 follow-up exam after 14 days of age or with ≥1 visit with development reported, respectively. RESULTS Among 2248 infants, 10.1% were born preterm, and 10.5% were small-for-gestational age. Overall, 122 (5.4%) had any ZBD; 91.8% of infants had brain abnormalities or microcephaly, 23.0% had eye abnormalities, and 14.8% had both. Of 1881 children ≥1 follow-up exam reported, neurologic sequelae were more common among children with ZBD (44.6%) vs. without ZBD (1.5%). Of children with ≥1 visit with development reported, 46.8% (51/109) of children with ZBD and 7.4% (129/1739) of children without ZBD had confirmed or possible developmental delay. CONCLUSION Understanding the prevalence of developmental delays and healthcare needs of children with congenital Zika virus exposure can inform health systems and planning to ensure services are available for affected families. IMPACT We characterize pregnancy and infant outcomes and describe neurodevelopmental abnormalities up to 36 months of age by presence of Zika associated birth defects (ZBD). Neurologic sequelae and developmental delays were common among children with ZBD. Children with ZBD had increased frequency of neurologic sequelae and developmental delay compared to children without ZBD. Longitudinal follow-up of infants with Zika virus exposure in utero is important to characterize neurodevelopmental delay not apparent in early infancy, but logistically challenging in surveillance models.
Collapse
Affiliation(s)
- Varsha Neelam
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kate R Woodworth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel J Chang
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Nicole M Roth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Megan R Reynolds
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amanda Akosa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Kayla N Anderson
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah B Mulkey
- Children's National Hospital, Washington, D. C., USA
- The George Washington University School of Medicine and Health Sciences, Washington, D. C., USA
| | - Roberta L DeBiasi
- Children's National Hospital, Washington, D. C., USA
- The George Washington University School of Medicine and Health Sciences, Washington, D. C., USA
| | - Cara Biddle
- Children's National Hospital, Washington, D. C., USA
- The George Washington University School of Medicine and Health Sciences, Washington, D. C., USA
| | - Ellen H Lee
- New York City Department of Health & Mental Hygiene, New York City, NY, USA
| | | | | | | | | | | | | | | | | | - Leah Lind
- Pennsylvania Department of Health, Pittsburgh, PA, USA
| | - Kyoo Shim
- Dallas County Health and Human Services, Dallas, TX, USA
| | | | | | - Shreya Khuntia
- District of Columbia Department of Health, Washington, D. C, USA
| | - Umme-Aiman Halai
- Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Autumn Locklear
- North Carolina Department of Health and Human Services, Chapel Hill, NC, USA
| | - Mary Chan
- Washington State Department of Health, Seattle, WA, USA
| | | | - Julius Tonzel
- Louisiana Department of Health, New Orleans, LA, USA
| | - Natalie S Marzec
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | | | - Connie Sanchez
- Hidalgo County Health & Human Services Department, Hidalgo, TX, USA
| | - Jane Fornoff
- Illinois Department of Public Health, Springfield, IL, USA
| | - Shelby Hale
- Ohio Department of Health, Columbus, OH, USA
| | - Amy Nance
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| | | | | | - Emily Potts
- Indiana Department of Health, Indianapolis, IN, USA
| | | | - Devin Raman
- Southern Nevada Health District, Las Vegas, NV, USA
| | | | | | - Elizabeth Ludwig
- Nebraska Department of Health and Human Services, Lincoln, NE, USA
| | - Lindsay Denson
- Oklahoma State Department of Health, Oklahoma City, OK, USA
| | | | - Paul A Romitti
- University of Iowa College of Public Health, Iowa City, IA, USA
| | - Emily Ferrell
- Kentucky Department for Public Health, Georgetown, KY, USA
| | - Meghan Marx
- South Dakota Department of Health, Pierre, SD, USA
| | - Kimberly Signs
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Amie Cook
- Kansas Department of Health and Environment, Topeka, KS, USA
| | - Vinita Oberoi Leedom
- South Carolina Department of Health and Environmental Control, Florence, SC, USA
| | - Suzann Beauregard
- New Hampshire Department of Health and Human Services, Concord, NH, USA
| | | | | | - Lesley Roush
- West Virginia Bureau for Public Health, Charleston, WV, USA
| | - Shana Godfred-Cato
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suzanne M Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Meaney-Delman
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Margaret A Honein
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Van T Tong
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
3
|
Nemechek K, Stefanos R, Miller EL, Riser A, Kebede B, Galang RR, Hufstetler K, Descamps D, Balenger A, Hennessee I, Neelam V, Hutchins HJ, Labuda SM, Davis KM, McCormick DW, Marx GE, Kimball A, Ruberto I, Williamson T, Rzucidlo P, Willut C, Harold RE, Mangla AT, English A, Brikshavana D, Blanding J, Kim M, Finn LE, Marutani A, Lockwood M, Johnson S, Ditto N, Wilton S, Edmond T, Stokich D, Shinall A, Alravez B, Crawley A, Nambiar A, Gateley EL, Schuman J, White SL, Davis K, Milleron R, Mendez M, Kawakami V, Segaloff HE, Bower WA, Ellington SR, McCollum AM, Pao LZ. Notes from the Field: Exposures to Mpox Among Cases in Children Aged ≤12 Years - United States, September 25-December 31, 2022. MMWR Morb Mortal Wkly Rep 2023; 72:633-635. [PMID: 37289653 PMCID: PMC10328459 DOI: 10.15585/mmwr.mm7223a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
|
4
|
Oakley LP, Hufstetler K, O’Shea J, Sharpe JD, McArdle C, Neelam V, Roth NM, Olsen EO, Wolf M, Pao LZ, Gold JAW, Davis KM, Perella D, Epstein S, Lash MK, Samson O, Pavlick J, Feldpausch A, Wallace J, Nambiar A, Ngo V, Halai UA, Richardson CW, Fowler T, Taylor BP, Chou J, Brandon L, Devasia R, Ricketts EK, Stockdale C, Roskosky M, Ostadkar R, Vang Y, Galang RR, Perkins K, Taylor M, Choi MJ, Weidle PJ, Dawson P, Ellington S. Mpox Cases Among Cisgender Women and Pregnant Persons - United States, May 11-November 7, 2022. MMWR Morb Mortal Wkly Rep 2023; 72:9-14. [PMID: 36602932 PMCID: PMC9815154 DOI: 10.15585/mmwr.mm7201a2] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Monkeypox (mpox) cases in the 2022 outbreak have primarily occurred among adult gay, bisexual, and other men who have sex with men (MSM); however, other populations have also been affected (1). To date, data on mpox in cisgender women and pregnant persons have been limited. Understanding transmission in these populations is critical for mpox prevention. In addition, among pregnant persons, Monkeypox virus can be transmitted to the fetus during pregnancy or to the neonate through close contact during or after birth (2-5). Adverse pregnancy outcomes, including spontaneous abortion and stillbirth, have been reported in previous mpox outbreaks (3). During May 11-November 7, 2022, CDC and U.S. jurisdictional health departments identified mpox in 769 cisgender women aged ≥15 years, representing 2.7% of all reported mpox cases.† Among cases with available data, 44% occurred in cisgender women who were non-Hispanic Black or African American (Black), 25% who were non-Hispanic White (White), and 23% who were Hispanic or Latino (Hispanic). Among cisgender women with available data, 73% reported sexual activity or close intimate contact as the likely route of exposure, with mpox lesions most frequently reported on the legs, arms, and genitals. Twenty-three mpox cases were reported in persons who were pregnant or recently pregnant§; all identified as cisgender women based on the mpox case report form.¶ Four pregnant persons required hospitalization for mpox. Eleven pregnant persons received tecovirimat, and no adverse reactions were reported. Continued studies on mpox transmission risks in populations less commonly affected during the outbreak, including cisgender women and pregnant persons, are important to assess and understand the impact of mpox on sexual, reproductive, and overall health.
Collapse
|
5
|
Neelam V, Reeves EL, Woodworth KR, O'Malley Olsen E, Reynolds MR, Rende J, Wingate H, Manning SE, Romitti P, Ojo KD, Silcox K, Barton J, Mobley E, Longcore ND, Sokale A, Lush M, Delgado‐Lopez C, Diedhiou A, Mbotha D, Simon W, Reynolds B, Hamdan TS, Beauregard S, Ellis EM, Seo JY, Bennett A, Ellington S, Hall AJ, Azziz‐Baumgartner E, Tong VT, Gilboa SM. Pregnancy and infant outcomes by trimester of SARS-CoV-2 infection in pregnancy-SET-NET, 22 jurisdictions, January 25, 2020-December 31, 2020. Birth Defects Res 2022; 115:145-159. [PMID: 36065896 PMCID: PMC9537929 DOI: 10.1002/bdr2.2081] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/04/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES We describe clinical characteristics, pregnancy, and infant outcomes in pregnant people with laboratory-confirmed SARS-CoV-2 infection by trimester of infection. STUDY DESIGN We analyzed data from the Surveillance for Emerging Threats to Mothers and Babies Network and included people with infection in 2020, with known timing of infection and pregnancy outcome. Outcomes are described by trimester of infection. Pregnancy outcomes included live birth and pregnancy loss (<20 weeks and ≥20 weeks gestation). Infant outcomes included preterm birth (<37 weeks gestation), small for gestational age, birth defects, and neonatal intensive care unit admission. Adjusted prevalence ratios (aPR) were calculated for pregnancy and selected infant outcomes by trimester of infection, controlling for demographics. RESULTS Of 35,200 people included in this analysis, 50.8% of pregnant people had infection in the third trimester, 30.8% in the second, and 18.3% in the first. Third trimester infection was associated with a higher frequency of preterm birth compared to first or second trimester infection combined (17.8% vs. 11.8%; aPR 1.44 95% CI: 1.35-1.54). Prevalence of birth defects was 553.4/10,000 live births, with no difference by trimester of infection. CONCLUSIONS There were no signals for increased birth defects among infants in this population relative to national baseline estimates, regardless of timing of infection. However, the prevalence of preterm birth in people with SARS-CoV-2 infection in pregnancy in our analysis was higher relative to national baseline data (10.0-10.2%), particularly among people with third trimester infection. Consequences of COVID-19 during pregnancy support recommended COVID-19 prevention strategies, including vaccination.
Collapse
Affiliation(s)
- Varsha Neelam
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Emily L. Reeves
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA,Eagle Global Scientific, LLCAtlantaGeorgiaUSA
| | - Kate R. Woodworth
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Emily O'Malley Olsen
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Megan R. Reynolds
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Joy Rende
- New Jersey Department of HealthTrentonNew JerseyUSA
| | | | - Susan E. Manning
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA,Massachusetts Department of Public HealthBostonMassachusettsUSA
| | - Paul Romitti
- University of Iowa College of Public HealthIowa CityIowaUSA
| | | | | | | | - Evan Mobley
- Missouri Department of Health and Senior ServicesJefferson CityMissouriUSA
| | | | - Ayomide Sokale
- Philadelphia Department of Public HealthPhiladelphiaPennsylvaniaUSA
| | - Mamie Lush
- Nebraska Department of Health and Human ServicesLincolnNebraskaUSA
| | | | - Abdoulaye Diedhiou
- South Carolina Department of Health and Environmental ControlColumbiaSouth CarolinaUSA
| | - Deborah Mbotha
- Washington State Department of HealthShorelineWashingtonUSA
| | - Wanda Simon
- Arkansas Department of HealthLittle RockArkansasUSA
| | | | | | - Suzann Beauregard
- New Hampshire Department of Health and Human ServicesConcordNew HampshireUSA
| | - Esther M. Ellis
- U.S. Virgin Islands Department of HealthChristianstedVirgin IslandsUSA
| | | | - Amanda Bennett
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA,Illinois Department of Public HealthChicagoIllinoisUSA
| | - Sascha Ellington
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Aron J. Hall
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Eduardo Azziz‐Baumgartner
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Van T. Tong
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| | - Suzanne M. Gilboa
- Centers for Disease Control and Prevention COVID‐19 Response, Epidemiology Task ForceAtlantaGeorgiaUSA
| |
Collapse
|
6
|
Roth NM, Woodworth KR, Godfred-Cato S, Delaney AM, Olson SM, Nahabedian JF, Reynolds MR, Jones AM, Neelam V, Valencia-Prado M, Delgado-López C, Lee EH, Ellis EM, Lake-Burger H, Tonzel JL, Higgins CA, Chan RL, Tong VT, Gilboa SM, Cragan JD, Honein MA, Moore CA. Identifying possible inaccuracy in reported birth head circumference measurements among infants in the US Zika Pregnancy and Infant Registry. Birth Defects Res 2022; 114:314-318. [PMID: 35332688 PMCID: PMC10391875 DOI: 10.1002/bdr2.1997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The US Zika Pregnancy and Infant Registry (USZPIR) monitors infants born to mothers with confirmed or possible Zika virus infection during pregnancy. The surveillance case definition for Zika-associated birth defects includes microcephaly based on head circumference (HC). METHODS We assessed birth and follow-up data from infants with birth HC measurements <3rd percentile and birthweight ≥10th percentile to determine possible misclassification of microcephaly. We developed a schema informed by literature review and expert opinion to identify possible HC measurement inaccuracy using HC growth velocity and longitudinal HC measurements between 2 and 12 months of age. Two or more HC measurements were required for assessment. Inaccuracy in birth HC measurement was suspected if growth velocity was >3 cm/month in the first 3 months or HC was consistently >25th percentile during follow-up. RESULTS Of 6,799 liveborn infants in USZPIR, 351 (5.2%) had Zika-associated birth defects, of which 111 had birth HC measurements <3rd percentile and birthweight ≥10th percentile. Of 84/111 infants with sufficient follow-up, 38/84 (45%) were classified as having possible inaccuracy of birth HC measurement, 19/84 (23%) had HC ≥3rd percentile on follow-up without meeting criteria for possible inaccuracy, and 27/84 (32%) had continued HC <3rd percentile. After excluding possible inaccuracies, the proportion of infants with Zika-associated birth defects including microcephaly decreased from 5.2% to 4.6%. CONCLUSIONS About one-third of infants in USZPIR with Zika-associated birth defects had only microcephaly, but indications of possible measurement inaccuracy were common. Implementation of this schema in longitudinal studies can reduce misclassification of microcephaly.
Collapse
Affiliation(s)
- Nicole M Roth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kate R Woodworth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shana Godfred-Cato
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Augustina M Delaney
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Eagle Global Scientific, LLC, Alpharetta, Georgia, USA
| | - Samantha M Olson
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- G2S Corporation, San Antonio, Texas, USA
| | | | - Megan R Reynolds
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Abbey M Jones
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Varsha Neelam
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Ellen H Lee
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Esther M Ellis
- US Virgin Islands Department of Health, Christiansted, US Virgin Islands, USA
| | | | | | | | - Ronna L Chan
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| | - Van T Tong
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suzanne M Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janet D Cragan
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Margaret A Honein
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cynthia A Moore
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
7
|
Griffin I, Woodworth KR, Galang RR, Burkel VK, Neelam V, Siebman S, Barton J, Manning SE, Aveni K, Longcore ND, Harvey EM, Ngo V, Mbotha D, Chicchelly S, Lush M, Eckert V, Dzimira P, Sokale A, Valencia-Prado M, Azziz-Baumgartner E, MacNeil A, Gilboa SM, Tong VT. Recurrent SARS-CoV-2 RNA Detection after COVID-19 Illness Onset during Pregnancy. Emerg Infect Dis 2022; 28:873-876. [PMID: 35213801 PMCID: PMC8962892 DOI: 10.3201/eid2804.212354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The Surveillance for Emerging Threats to Mothers and Babies Network conducts longitudinal surveillance of pregnant persons in the United States with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection during pregnancy. Of 6,551 infected pregnant persons in this analysis, 142 (2.2%) had positive RNA tests >90 days and up to 416 days after infection.
Collapse
|
8
|
Woodworth KR, Olsen EO, Neelam V, Lewis EL, Galang RR, Oduyebo T, Aveni K, Yazdy MM, Harvey E, Longcore ND, Barton J, Fussman C, Siebman S, Lush M, Patrick PH, Halai UA, Valencia-Prado M, Orkis L, Sowunmi S, Schlosser L, Khuwaja S, Read JS, Hall AJ, Meaney-Delman D, Ellington SR, Gilboa SM, Tong VT. Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy - SET-NET, 16 Jurisdictions, March 29-October 14, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1635-1640. [PMID: 33151917 PMCID: PMC7643898 DOI: 10.15585/mmwr.mm6944e2] [Citation(s) in RCA: 271] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
9
|
Lim S, Neelam V, Patel N, Thakkar M, Bollu P. Efficacy of Amitriptyline as a Prophylactic Agent for Headaches in Pediatric Population (P04.171). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
10
|
Neelam V, Lim S, Singh N. Neuropathy, Encephalopathy, Lambert-Eaton Myasthenic Syndrome and Myasthenia Gravis in a Non-Small Cell Neuroendocrine Tumor of the Lung - An Interesting Paraneoplastic Syndrome: Case Report and Review of Literature. (NELM Syndrome) (P04.094). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
11
|
Singh N, Neelam V, Lim S. Demographic and Clinical Features of Ocular Myasthenia Gravis and Identification of Prognostic Factors: A Retrospective Study (P05.180). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
12
|
Lim S, Neelam V, Singh N. Image Separation of 1 mm at 2 Minute Sustained Lateral Gaze: The Most Characteristic Bedside Diagnostic Feature for Ocular Myasthenia Gravis: A Review of 65 Cases of Diplopia Referral (P05.179). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
13
|
Abstract
OBJECTIVE To evaluate the usefulness of polymerase chain reaction (PCR) compared with the conventional mycologic methods in the diagnosis of fungal endophthalmitis. DESIGN Prospective comparative validation of diagnostic testing-case-control study. PARTICIPANTS AND CONTROLS Thirty subjects in whom fungal endophthalmitis was suspected and 20 controls with noninfections. INTERVENTION TESTING: Collection of intraocular specimens and testing for the presence of fungus by PCR and conventional methods. MAIN OUTCOME MEASURES Detection of fungus by microscopy, growth by culture, and fungal DNA by PCR for definitive and rapid diagnosis of fungal endophthalmitis. RESULTS None of the controls was positive by microscopy, culture, or PCR. Among the 43 intraocular specimens from 30 subjects, 24 were positive by conventional mycologic methods and 32 were positive by PCR. PCR increased the sensitivity of detection by 18.6%, which was statistically significant (McNemar test: P = 0.039). CONCLUSIONS PCR was a more sensitive and rapid diagnostic tool compared with the conventional mycologic methods in the diagnosis of fungal endophthalmitis.
Collapse
Affiliation(s)
- A Anand
- Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | | | | | | |
Collapse
|
14
|
Sumitra D, Kumar S, Neelam V, Sarode R, Verma S. A case of erythroleukaemia with partial expression of fetal red cell markers. J Assoc Physicians India 1988; 36:620. [PMID: 2464574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|