ABSTRACT
Recently, new noninvasive prenatal genetic screening technologies for Down syndrome and other genetic conditions have become commercially available. Unique characteristics of these screening tests have reignited long-standing concerns about prenatal testing for intellectual and developmental disabilities. We conducted a web-based survey of a sample of the US public to examine how attitudes towards disability inform views of prenatal testing in the context of these rapidly advancing prenatal genetic screening technologies. Regardless of opinion toward disability, the majority of respondents supported both the availability of screening and the decision to continue a pregnancy positive for aneuploidy. Individuals rationalized their support with various conceptions of disability; complications of the expressivist argument and other concerns from the disability literature were manifested in many responses analyzed.
Subject(s)
Disabled Persons , Down Syndrome/diagnosis , Down Syndrome/psychology , Genetic Testing/methods , Prenatal Diagnosis/psychology , Public Opinion , Adult , Aneuploidy , Attitude to Health , Down Syndrome/genetics , Female , Humans , Male , PregnancyABSTRACT
Zika virus infection during pregnancy is associated with miscarriage and with a broad spectrum of fetal and neonatal developmental abnormalities collectively known as congenital Zika syndrome (CZS). Symptomology of CZS includes malformations of the brain and skull, neurodevelopmental delay, seizures, joint contractures, hearing loss and visual impairment. Previous studies of Zika virus in pregnant rhesus macaques (Macaca mulatta) have described injury to the developing fetus and pregnancy loss, but neonatal outcomes following fetal Zika virus exposure have yet to be characterized in nonhuman primates. Herein we describe the presentation of rhesus macaque neonates with a spectrum of clinical outcomes, including one infant with CZS-like symptoms including cardiomyopathy, motor delay and seizure activity following maternal infection with Zika virus during the first trimester of pregnancy. Further characterization of this neonatal nonhuman primate model of gestational Zika virus infection will provide opportunities to evaluate the efficacy of pre- and postnatal therapeutics for gestational Zika virus infection and CZS.
Subject(s)
Disease Models, Animal , Zika Virus Infection/veterinary , Zika Virus/pathogenicity , Animals , Cardiomyopathies/virology , Female , Fetus/virology , Macaca mulatta , Microcephaly/virology , Pregnancy , Pregnancy Complications, Infectious/veterinary , Pregnancy Complications, Infectious/virology , Pregnancy Trimester, First , Seizures/virology , Zika Virus Infection/virologyABSTRACT
Zika virus (ZIKV) infection during pregnancy causes congenital abnormalities, including microcephaly. However, rates vary widely, and the contributing risk factors remain unclear. We examined the serum antibody response to ZIKV and other flaviviruses in Brazilian women giving birth during the 2015-2016 outbreak. Infected pregnancies with intermediate or higher ZIKV antibody enhancement titers were at increased risk to give birth to microcephalic infants compared with those with lower titers (P < 0.0001). Similarly, analysis of ZIKV-infected pregnant macaques revealed that fetal brain damage was more frequent in mothers with higher enhancement titers. Thus, features of the maternal antibodies are associated with and may contribute to the genesis of ZIKV-associated microcephaly.
Subject(s)
Antibodies, Viral/immunology , Maternal-Fetal Exchange/immunology , Microcephaly/immunology , Pregnancy Complications, Infectious/immunology , Zika Virus Infection/immunology , Zika Virus/immunology , Animals , Brain/embryology , Brain/immunology , Brain/pathology , Female , Fetus/embryology , Fetus/immunology , Fetus/pathology , Humans , K562 Cells , Macaca mulatta , Macaca nemestrina , Microcephaly/pathology , Pregnancy , Pregnancy Complications, Infectious/pathology , Zika Virus Infection/pathologyABSTRACT
Zika virus (ZIKV) infection is associated with congenital defects and pregnancy loss. Here, we found that 26% of nonhuman primates infected with Asian/American ZIKV in early gestation experienced fetal demise later in pregnancy despite showing few clinical signs of infection. Pregnancy loss due to asymptomatic ZIKV infection may therefore be a common but under-recognized adverse outcome related to maternal ZIKV infection.