Maternal Infection and Adverse Pregnancy Outcomes among Pregnant Travellers: Results of the International Zika Virus in Pregnancy Registry
Manon Vouga,
Léo Pomar,
Antoni Soriano-Arandes,
Carlota Rodó,
Anna Goncé,
Eduard Gratacos,
Audrey Merriam,
Isabelle Eperon,
Begoña Martinez De Tejada,
Béatrice Eggel,
Sophie Masmejan,
Laurence Rochat,
Blaise Genton,
Tim Van Mieghem,
Véronique Lambert,
Denis Malvy,
Patrick Gérardin,
David Baud,
Alice Panchaud
Affiliations
Manon Vouga
Materno-Fetal and Obstetrics Research Unit, Department “Woman-Mother-Child”, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Léo Pomar
Materno-Fetal and Obstetrics Research Unit, Department “Woman-Mother-Child”, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Antoni Soriano-Arandes
Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
Carlota Rodó
Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
Anna Goncé
Institut Clínic de Ginecología, Obstetricia i Neonatologia and BCNatal (Barcelona Center for Maternal-Fetal and Neonatal Medicine), Hospital Clínic and Hospital Sant Joan de Deu, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Center for Biomedical Research on Rare Diseases (CIBERER), 08028 Barcelona, Spain
Eduard Gratacos
Institut Clínic de Ginecología, Obstetricia i Neonatologia and BCNatal (Barcelona Center for Maternal-Fetal and Neonatal Medicine), Hospital Clínic and Hospital Sant Joan de Deu, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Center for Biomedical Research on Rare Diseases (CIBERER), 08028 Barcelona, Spain
Audrey Merriam
Department of Obstetrics and Gynecology, New York Presbyterian Hospital Columbia University, New York, NY 10032, USA
Isabelle Eperon
Department of Obstetrics and Gynecology, University Hospitals of Geneva, 1205 Geneva, Switzerland
Begoña Martinez De Tejada
Department of Obstetrics and Gynecology, University Hospitals of Geneva, 1205 Geneva, Switzerland
Béatrice Eggel
Obstetrics and Gynecology Department, Centre Hospitalier du Centre Valais (CHCVs), 1950 Sion, Switzerland
Sophie Masmejan
Materno-Fetal and Obstetrics Research Unit, Department “Woman-Mother-Child”, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Laurence Rochat
Center for Primary Care and Public Health, University of Lausanne, 1011 Lausanne, Switzerland
Blaise Genton
Center for Primary Care and Public Health, University of Lausanne, 1011 Lausanne, Switzerland
Tim Van Mieghem
Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, ON M5G 1X5, Canada
Véronique Lambert
Department of Obstetrics and Gynecology, Centre Hospitalier-Franck Joly, 97393 Saint-Laurent du Maroni, French Guiana
Denis Malvy
Department for Infectious and Tropical Diseases, CHU Hôpitaux de Bordeaux and Inserm 1219, University of Bordeaux, 33000 Bordeaux, France
Patrick Gérardin
INSERM CIC1410 Clinical Epidemiology, Centre Hospitalier Universitaire de la Réunion, 97410 Saint Pierre La Réunion, France
David Baud
Materno-Fetal and Obstetrics Research Unit, Department “Woman-Mother-Child”, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Alice Panchaud
School of Pharmaceutical Sciences, Geneva University and Service of Pharmacy, Lausanne University Hospital, 1011 Lausanne, Switzerland
In this multicentre cohort study, we evaluated the risks of maternal ZIKV infections and adverse pregnancy outcomes among exposed travellers compared to women living in areas with ZIKV circulation (residents). The risk of maternal infection was lower among travellers compared to residents: 25.0% (n = 36/144) versus 42.9% (n = 309/721); aRR 0.6; 95% CI 0.5–0.8. Risk factors associated with maternal infection among travellers were travelling during the epidemic period (i.e., June 2015 to December 2016) (aOR 29.4; 95% CI 3.7–228.1), travelling to the Caribbean Islands (aOR 3.2; 95% CI 1.2–8.7) and stay duration >2 weeks (aOR 8.7; 95% CI 1.1–71.5). Adverse pregnancy outcomes were observed in 8.3% (n = 3/36) of infected travellers and 12.7% (n = 39/309) of infected residents. Overall, the risk of maternal infections is lower among travellers compared to residents and related to the presence of ongoing outbreaks and stay duration, with stays <2 weeks associated with minimal risk in the absence of ongoing outbreaks.
