Table 3. Results of the reviewed studies.
| SG | C | R | Age of mother (years) | Main clinical characteristics | Laboratory test for ZIKAV | Breastfeeding behavior | |||
|---|---|---|---|---|---|---|---|---|---|
| Mothera | Childa | Mothera | Breast milka | Childa | |||||
| I | 1 | 1 | Early 30s | Mild rash/−2 to 2 No fever/−2 to 2 Recovered favorably | VD: 38 weeks of gestation Apgar 10-10 Unremarkable/1 to 5 Evolved favorably | Serumb (+) 7.0 × 104/2 Salivab (+)/2 | b (+) 205 × 104/3 Cell culture no replicative particles/3 | Serumb (+) 65 × 104/3 Salivab (+)/3 | Breastfeeding began on day of delivery |
| F1 | 2 | NA | NA | 32 months old Remained asymptomatic Normal neurological development CDAS do not indicate neurocognitive problems | NA | NA | Breastfed for 2 months | ||
| I | 2 | 3 | 27 | Fever /0-2 Maculopapular rash/2 Recovered favorably | VD: 37 weeks of gestation Apgar 10 Evolved favorably Asymptomatic | Serumb (+) 3.5 × 104/3 | b (+) 85.0 × 104/4 Cell culture infective particles/4 | Serumb (A)/3 | Breastfeeding began on day of delivery |
| F2 | 4 | NA | NA | Personal communication: no long term complications at 8 months of age | NA | NA | NA | NA | |
| I | 3 | 5 | 33 | 28 weeks of gestation Macular exanthema on the trunk/1 Exanthema on trunk, arms and legs/2-3 Arthralgia/3-5 Asymptomatic/30 Asymptomatic/postpartum | 4 month-old healthy girl No malformation No neuro-ophthalmological findings | Urineb NAM (−)/3-5 Serumb (+) CT37.5∕3 − 5 Serumb NAM (−)/30 Urineb (+) CT 38.5/30 Serumb NAM (−)/during 4 months postpartum Urineb NAM (−)/during the first 4 months postpartum | b NAM (−)/during 4 months postpartum | Serumb NAM (−)/during the first 4 months postpartum Urine NAM (−)/during the first 4 months postpartum IgM (−)/during the first 4 months postpartum | Breastfed for 4 months after birth |
| I | 4 | 6 | 28 | 36 weeks of gestation Fever, articular pain, myalgia and rash/−23 After delivery, remained in good clinical condition | D: 38 weeks of gestation Birthweight: 2860 g Apgar 9-10 No evidence of growth restriction, microcephaly, cerebral calcifications After birth, remained in good clinical condition | Bloodb (+)/−22 Bloodb (−)/−19 Urineb (+)/−19 Bloodb (−)/−18 Urineb (+)/−18 Bloodb (−)/−9 Urineb (+)/−9 | b (+) 244 × 104/−9 Cell culture infective particles/−9 b (+)/0 b (+) 21.6 × 104/9 Cell culture infective particles/9 | Urineb (−)/0 Placentab (−)/0 Cord bloodb (−)/0 Amniotic fluidb (−)/0 | No breastfeeding |
| I | 5 | 7 | 32 | 9 weeks of gestation Diffuse pruritic rash, joint pain | At 22 weeks of gestation ultrasound revealed alteration on left hand, which confirmed at 23 weeks of gestation CD: 38 weeks of gestation Birthweight: 2502 g Severe microcephaly After birth, alteration on left hand is supported by X-ray Possible amniotic band syndrome | c Serum (−)/NR | bPrevented detection/2 c (+)/2 Viral genome sequence | Bloodb prevented detection /0 Urineb prevented detection/0 Placentab (+) CT 33 Urine (+)c/1 Serum (+)c/1 Urine and serum viral genome sequence Complete genome clustered with 86 bootstrap support with mother strain | NR |
| II | 6 | 1 | Early 40s | Gestational diabetes Intrauterine growth restriction Pregnancy complications Mild fever, rash and myalgia/3 Recovered favorably | CD: 38 weeks of gestation Severe hypotrophy Apgar 8-9-9 Leukopenia and thrombocytopenia/3 Rash and neonatal jaundice/4 Evolved favorably | Serumb (+) 59 × 104/1 Serumb (+) 2.6 × 104/5 Serumb (−)/8 Urineb (+) 16 × 104/8 Serumb (−)/11 Serumb (−)/13 | b (+) 2.9 × 104/8 Cell culture no replicative particles/8 | Serum b (−)/0 Serumb (−)/3 Serumb (+) 62 × 104/4 Serumb (+) 69 × 104/7 Urineb (+) 20 × 104/8 Urineb (−)/11 | Enteral nutrition with artificial milk began on day of delivery Breastfeeding began on day 3 |
| F6 | 2 | NA | NA | Approx. 30 months-old Prolonged subclinical hepatitis resolved after 4 months CDAS scores indicated no neurocognitive problems | NA | NA | Breastfed for 6 months | ||
| IV | 7 | 5 | 42 | Fever, retro-ocular pain, conjunctival hyperemia, arthralgia rash on face, trunk and members/1-2 Fading exanthema and arthralgia/5 | 2-3 month-old girl Asymptomatic/5 | SerumbNAM (−)/5 Urineb (+) CT 36.2/5 | b NAM (−)/5 | Not tested | Breastfeeding while mother symptomatic |
| IV | 8 | 8,9 | 32 | Conjunctival hyperemia, pruritic and maculopapular rash/1-5 Malaise, arthralgia/1-11 | 5 months old Asymptomatic/1-11 | Urineb (+) CT 26.73/5 IgM (+)/5 IgG borderline/5 | b (+)/5 Cell culture (+) cytopathic effect/5 Viral genome sequence | Plasmab (+) CT 35.57/5 Urineb (+) CT 35.36/5 Urine viral genome sequence Complete genome clustered with 99% bootstrap support with mother strain | Exclusively breastfed |
| V | 9 | 5 | 33 | Malaise, fever/1 Rash on face, trunk and arms/2 Exanthema both legs/4 Asymptomatic/10 Asymptomatic/17 | 11 month-old boy Asymptomatic/1 Asymptomatic/3 Asymptomatic/17 | Serumb (+) CT 33.4/3 Urineb (+) CT 33.1/3 Serumb NAM (−)/17 Urineb NAM (−)/17 | bCT (+) 36.7/4 Cell culture infective particles/4 bNAM (−) /17 | Urineb (−)/10 | Breastfeeding avoided for 7 days after maternal rash and restarted 4 days after maternal rash disappeared |
| V | 10 | 5 | 28 | 1 month of gestation Fever, conjunctival hyperemia, arthralgia and exanthema/1-3 Arthralgia and exanthema relapse/5-6 Rash and arthralgia/7 Asymptomatic/9 | 10-11 month-old boy Mild infection: fever and exanthema/lasting 2 days No signs or symptoms/5-6 Asymptomatic/7-9 | Serumb (+) CT38/7 Serumb NAM (−)/9 Urineb (−) CT 38.8/9 | bNAM (−)/9 | Serumb (−)/7 | Breastfeeding while mother symptomatic Child serum CHIKV (+)CT36.3b/7 |
Notes.
- SG
- Subgroup by timing of maternal ZIKAV disease
- ZIKAV
- Zika virus
- R
- reference
- C
- case
- F
- follow up of case
- VD
- vaginal delivery
- CD
- caesarean delivery
- D
- delivery
- CDAS
- Child development assessment scale
- NAM
- No amplification
- A
- interpreted as ambiguous result by authors
- NR
- Not reported
- NA
- Not applicable
- CT
- cycle threshold
- CHIK
- Chikungunya virus
(+) Interpreted as a positive result by authors.
(−) Interpreted as a negative result by authors.
Subgroups according to timing of maternal ZIKAV disease.
- I
- Prenatal, time before delivery
- II
- Immediate postnatal, period from 0 to 4 days
- III
- Medium postnatal, period from 5 days to 8 weeks
- IV
- : Long postnatal, period from 8 weeks to 6 months
- V
- period beyond 6 months
a
Depending on the case, a negative number after the diagonal symbol means days before delivery, a positive number means days after delivery, where 0 is the day of delivery considering the onset of maternal ZIKAV disease symptoms or mean number of days elapsed since the onset of maternal ZIKAV disease symptoms.
b
Real time reverse transcription polymerase chain reaction units: CT or copies/mL (quantitative PCR).
c
Nested PCR against NS5 ZIVAV (426 bp).