Table 3. Adjusted Associations Between Prenatal Ultrasonographic Result and Neonatal Outcomes Among Women Diagnosed During Pregnancy With Zika Virus Infection.
| Ultrasonographic Result | Neonatal Examination | Postnatal Neuroimaging | Composite Neonatal Outcome | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Normal Result, No. (%) (n = 51) | Abnormal Result, No. (%) (n = 41)a | aOR (95% CI) | Normal Result, No. (%) (n = 45) | Abnormal Result, No. (%) (n = 23) | aOR (95% CI)b | P Value | Normal Result, No. (%) (n = 47) | Abnormal Result, No. (%) (n = 45)a | aOR (95% CI)b | P Value | |
| Any abnormal finding (n = 37) | 17 (33.3) | 20 (48.8) | 2.15 (0.9-5.3) | 16 (35.6) | 12 (52.2) | 1.5 (0.5-4.4) | 15 (31.9) | 22 (48.9) | 2.4 (1.0-5.8) | ||
| Zika virus–associated abnormal finding (n = 11)c | 2 (3.9) | 9 (22.0) | 11.6 (1.8-72.8) | 2 (4.4) | 7 (30.4) | 6.7 (1.1-38.9) | 1 (2.1) | 10 (22.2) | 27.2 (2.5-296.6) | ||
| CNS abnormality (n = 10) | 2 (3.9) | 8 (19.5) | 11.0 (1.7-73.4) | 1 (2.2) | 7 (30.4) | 13.9 (1.4-140.0) | 1 (2.1) | 9 (20.0) | 27.2 (2.4-310.5) | ||
| Microcephaly (n = 7) | 1 (2.0) | 6 (14.6) | 23.4 (1.8-296.5) | 0 | 5 (21.7) | NA | .003d | 1 (2.1) | 6 (13.3) | 17.8 (1.4-218.9) | |
| Calcifications (n = 9) | 2 (3.9) | 7 (17.1) | 9.2 (1.4-61.6) | 1 (2.2) | 6 (26.1) | 11.5 (1.1-118.1) | 1 (2.1) | 8 (17.8) | 22.8 (2.0-257.2) | ||
| Ventriculomegaly (n = 6) | 1 (2.0) | 5 (12.2) | 12.8 (1.1-150.0) | 0 | 5 (21.7) | NA | .003d | 0 | 6 (13.3) | NA | .01d |
| Fetal growth restriction (n = 7) | 1 (2.0) | 6 (14.3) | 18.7 (1.5-229.5) | 1 (2.2) | 4 (17.4) | 4.9 (0.4-57.5) | 1 (2.1) | 6 (13.3) | 14.6 (1.2-175.0) | ||
| Ultrasonographic findings of unknown significance (n = 37) | 17 (33.3) | 20 (48.8) | 2.2 (0.9-5.3) | 16 (35.6) | 12 (52.2) | 1.5 (0.5-4.4) | 15 (31.9) | 22 (48.9) | 2.4 (1.0-5.8) | ||
| Without Zika virus–associated finding (n = 26) | 15 (29.4) | 11 (26.8) | 0.9 (0.4-2.3) | 14 (31.1) | 5 (21.7) | 0.6 (0.2-2.0) | 14 (29.8) | 12 (26.7) | 0.9 (0.4-2.2) | ||
| Abnormal Doppler results (n = 17) | 4 (7.8) | 13 (31.7) | 7.0 (2.0-31.3) | 4 (8.9) | 9 (39.1) | 4.6 (1.1-20.5) | 4 (8.5) | 13 (28.9) | 6.0 (1.6-23.5) | ||
| Umbilical artery (n = 5) | 2 (3.9) | 3 (7.3) | 2.2 (0.3-14.1) | 2 (4.4) | 2 (8.7) | 1.3 (0.2-11.7) | 2 (4.3) | 3 (6.7) | 1.8 (0.3-11.6) | ||
| Middle cerebral artery (n = 16) | 3 (5.9) | 13 (31.7) | 12.8 (2.6-63.2) | 3 (6.7) | 10 (43.5) | 8.8 (1.7-45.9) | 2 (4.3) | 14 (31.1) | 20.5 (3.2-132.6) | ||
| Fluid abnormalities (n = 13) | 5 (9.8) | 8 (19.5) | 2.4 (0.7-8.9) | 6 (13.3) | 6 (26.1) | 1.4 (0.3-5.7) | 5 (10.6) | 8 (17.8) | 2.0 (0.5-7.1) | ||
| Oligohydramnios (n = 6) | 1 (2.0) | 5 (12.2) | 13.5 (1.1-170.3) | 2 (4.4) | 4 (17.4) | 2.2 (0.2-18.2) | 1 (2.1) | 5 (11.1) | 10.8 (0.9-133.7) | ||
| Polyhydramnios (n = 7) | 4 (7.8) | 3 (7.3) | 0.9 (0.2-4.2) | 4 (8.9) | 2 (8.7) | 1.0 (0.2-6.1) | 4 (8.5) | 3 (6.7) | 0.8 (0.2-3.6) | ||
Abbreviations: aOR, adjusted odds ratio; CNS, central nervous system; NA, not available.
a
The stillbirth case was included and considered to have an abnormal finding on neonatal examination and composite adverse neonatal outcome.
b
The aORs and 95% CIs were calculated by logistic regression, adjusting for maternal age and number of ultrasonographic examinations.
c
Zika virus–associated CNS anomalies included microcephaly, calcifications, ventriculomegaly, Blake pouch cyst, cerebellar vermian hypoplasia, and agenesis of the corpus callosum. Most common findings are shown. See eTable 4 in the Supplement for complete results.
d
When ORs were unable to be calculated, the Fisher exact test was performed and 2-way P values are presented.