title: Baseline Prevalence of Birth Defects Associated with Congenital Zika Virus Infection - Massachusetts, North Carolina, and Atlanta, Georgia, 2013-2014.
abstract: Zika virus infection during pregnancy can cause serious brain abnormalities, but the full range of adverse outcomes is unknown (1). To better understand the impact of birth defects resulting from Zika virus infection, the CDC surveillance case definition established in 2016 for birth defects potentially related to Zika virus infection* (2) was retrospectively applied to population-based birth defects surveillance data collected during 2013-2014 in three areas before the introduction of Zika virus (the pre-Zika years) into the World Health Organization's Region of the Americas (Americas) (3). These data, from Massachusetts (2013), North Carolina (2013), and Atlanta, Georgia (2013-2014), included 747 infants and fetuses with one or more of the birth defects meeting the case definition (pre-Zika prevalence = 2.86 per 1,000 live births). Brain abnormalities or microcephaly were the most frequently recorded (1.50 per 1,000), followed by neural tube defects and other early brain malformations†(0.88), eye abnormalities without mention of a brain abnormality (0.31), and other consequences of central nervous system (CNS) dysfunction without mention of brain or eye abnormalities (0.17). During January 15-September 22, 2016, the U.S. Zika Pregnancy Registry (USZPR) reported 26 infants and fetuses with these same defects among 442 completed pregnancies (58.8 per 1,000) born to mothers with laboratory evidence of possible Zika virus infection during pregnancy (2). Although the ascertainment methods differed, this finding was approximately 20 times higher than the proportion of one or more of the same birth defects among pregnancies during the pre-Zika years. These data demonstrate the importance of population-based surveillance for interpreting data about birth defects potentially related to Zika virus infection.
authors.forename: Janet D
authors.initials: JD
authors.lastname: Cragan
authors.forename: Cara T
authors.initials: CT
authors.lastname: Mai
authors.forename: Emily E
authors.initials: EE
authors.lastname: Petersen
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Liberman
authors.forename: Nina E
authors.initials: NE
authors.lastname: Forestieri
authors.forename: Alissa C
authors.initials: AC
authors.lastname: Stevens
authors.forename: Augustina
authors.initials: A
authors.lastname: Delaney
authors.forename: April L
authors.initials: AL
authors.lastname: Dawson
authors.forename: Sascha R
authors.initials: SR
authors.lastname: Ellington
authors.forename: Carrie K
authors.initials: CK
authors.lastname: Shapiro-Mendoza
authors.forename: Julie E
authors.initials: JE
authors.lastname: Dunn
authors.forename: Cathleen A
authors.initials: CA
authors.lastname: Higgins
authors.forename: Robert E
authors.initials: RE
authors.lastname: Meyer
authors.forename: Tonya
authors.initials: T
authors.lastname: Williams
authors.forename: Kara N D
authors.initials: KN
authors.lastname: Polen
authors.forename: Kim
authors.initials: K
authors.lastname: Newsome
authors.forename: Megan
authors.initials: M
authors.lastname: Reynolds
authors.forename: Jennifer
authors.initials: J
authors.lastname: Isenburg
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Gilboa
authors.forename: Dana M
authors.initials: DM
authors.lastname: Meaney-Delman
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Moore
authors.forename: Coleen A
authors.initials: CA
authors.lastname: Boyle
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Honein
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008404:Massachusetts / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D015995:Prevalence; D012189:Retrospective Studies; D000071243:Zika Virus Infection / Q000151:congenital*