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1.
Pediatr Res ; 95(2): 558-565, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37658124

RESUMO

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.


Assuntos
Microcefalia , Transtornos do Neurodesenvolvimento , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Lactente , Recém-Nascido , Gravidez , Criança , Feminino , Humanos , Pré-Escolar , Infecção por Zika virus/complicações , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/congênito , Complicações Infecciosas na Gravidez/epidemiologia , Microcefalia/epidemiologia , Transtornos do Neurodesenvolvimento/complicações
2.
MMWR Morb Mortal Wkly Rep ; 69(44): 1635-1640, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33151917

RESUMO

Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness and might be at risk for preterm birth (1-3). The full impact of infection with SARS-CoV-2, the virus that causes COVID-19, in pregnancy is unknown. Public health jurisdictions report information, including pregnancy status, on confirmed and probable COVID-19 cases to CDC through the National Notifiable Diseases Surveillance System.* Through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET), 16 jurisdictions collected supplementary information on pregnancy and infant outcomes among 5,252 women with laboratory-confirmed SARS-CoV-2 infection reported during March 29-October 14, 2020. Among 3,912 live births with known gestational age, 12.9% were preterm (<37 weeks), higher than the reported 10.2% among the general U.S. population in 2019 (4). Among 610 infants (21.3%) with reported SARS-CoV-2 test results, perinatal infection was infrequent (2.6%) and occurred primarily among infants whose mother had SARS-CoV-2 infection identified within 1 week of delivery. Because the majority of pregnant women with COVID-19 reported thus far experienced infection in the third trimester, ongoing surveillance is needed to assess effects of infections in early pregnancy, as well the longer-term outcomes of exposed infants. These findings can inform neonatal testing recommendations, clinical practice, and public health action and can be used by health care providers to counsel pregnant women on the risks of SARS-CoV-2 infection, including preterm births. Pregnant women and their household members should follow recommended infection prevention measures, including wearing a mask, social distancing, and frequent handwashing when going out or interacting with others or if there is a person within the household who has had exposure to COVID-19.†.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez/epidemiologia , Aborto Espontâneo/epidemiologia , Adulto , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Laboratórios , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Medição de Risco , SARS-CoV-2 , Estados Unidos/epidemiologia , Adulto Jovem
3.
Matern Fetal Med ; 4(2): 127-129, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36338579

RESUMO

Maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the second and third trimesters of pregnancy may impact fetal development via vertical transmission, complications of coronavirus disease 2019 (COVID-19), or placental injury. However, potential associations between prenatal SARS-CoV-2 infection and fetal loss are not well understood. This case series of thirteen second and third trimester fetal losses reported by local public health departments to California's state public health surveillance included maternal clinical and demographic characteristics as well as placental pathology, fetal autopsy reports, and coroner report. There was no evidence that maternal COVID-19 disease severity, placental injury, or SARS-CoV-2 vertical transmission contributed to pregnancy loss. However, this case series is a limited sample; more research is needed to identify factors of prenatal SARS-CoV-2 that may contribute to fetal death in the second and third trimesters.

4.
AMIA Annu Symp Proc ; 2017: 1450-1457, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29854214

RESUMO

National initiatives on Electronic Health Records (EHRs) recognize the vital role of public health and recommend reporting to Immunization Information Systems (IIS) and access of its clinical decision support for immunizations (CDSi). The objective of this study was to collect stakeholder feedback on access and utilization of CDSi from the Minnesota Immunization Information Connection (MIIC), Minnesota's IIS. Input was solicited using a semi-structured questionnaire developed by experts, and from a sample of 17 key informants from February 2015 through May 2016. Analysis highlighted the appreciation of MIIC services, comprehensive vaccination history across providers and CDSi functionality, with public health users relying on MIIC. It also identified issues such as data entry due to read-only view, data quality and communications for improvement. These findings underscore the critical role of IIS, need to engage stakeholders, ensure CDSi updates, maintain good data quality, and promote bi-directional data exchanges across EHRs-IIS.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Registros Eletrônicos de Saúde , Programas de Imunização , Sistemas de Informação , Vacinação/estatística & dados numéricos , Confiabilidade dos Dados , Retroalimentação , Humanos , Serviços de Informação , Minnesota , Prática de Saúde Pública
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