Understanding the Impact of Zika during Pregnancy Globally

The devastating scale of the Zika virus outbreaks in Colombia and Brazil drove the CDC to work with health departments in both countries to track and care for mothers and babies. This work, supported in part by the United States Agency for International Development (USAID), will help CDC better understand the long-term outcomes of Zika virus infection during pregnancy and provide a common defense against the unprecedented challenges posed by Zika virus infection during pregnancy.

Proyecto Vigilancia de Embarazadas con Zika

CDC, in partnership with the Instituto Nacional de Salud (INS) and Ministry of Health in Colombia, worked on the Proyecto Vigilancia de Embarazadas con Zika (VEZ). Proyecto VEZ was an enhanced surveillance project that tracked the health of pregnant people with Zika virus infection and their infants in areas in Colombia with the highest number of people with Zika virus infection during pregnancy. Through this collaboration, CDC and INS hope to better understand

• The full range of potential health problems that congenital Zika virus infection might cause
• The risk of poor outcomes among fetuses and infants of people infected with Zika during pregnancy
• When during pregnancy Zika virus infection poses the highest risk to the fetus
• CDC and INS are currently analyzing the data collected from this project.

For more information, see:

• Pregnancy, Birth, Infant, and Early Childhood Neurodevelopmental Outcomes among a Cohort of Women with Symptoms of Zika Virus Disease during Pregnancy in Three Surveillance Sites, Project Vigilancia de Embarazadas con Zika (VEZ), Colombia, 2016–2018external icon

Zika en Embarazadas y Niños

Zika en Embarazadas y Niños (ZEN) is a research study in Columbia that includes pregnant people in their first trimester, their male partners, and their babies. Infants born to mothers enrolled in the study during pregnancy were followed up to six months of age. A subset of children, along with a parent or legal guardian, were followed until the child is about 18 months old. The ZEN study aims to

• Advance the understanding of short- and long-term health and developmental consequences of Zika virus infection during pregnancy and the health of affected children
  • Identify and describe how parents are affected by health issues of their children
• Inform and improve clinical care and guidelines related to the long-term care of children who were affected by Zika virus infection
• Provide critical information leading to evidence-based strategies to prevent Zika virus infection and other infections in pregnancy
• Improve counseling of patients about risks to themselves, their pregnancies, and their children
• Increase the preparedness of agencies providing services to affected children and families

For more information, see:

• Epidemiology of cytomegalovirus Infection among mothers and infants in Colombiaexternal icon
• Cohort profile: congenital Zika virus infection and child neurodevelopmental outcomes in the ZEN cohort study in Colombiaexternal icon.

Case Investigation

Colombia’s INS has a robust national public health tracking system for notifiable conditions, including birth defects, and has monitored the Zika virus outbreak closely since it began. CDC has provided technical assistance to INS in the investigation of all infants born with microcephaly or other central nervous system defects to determine whether they are attributable to Zika.

For more information, see:

• Zika Virus Disease and Pregnancy Outcomes in Colombiaexternal icon
• Preliminary Report of Microcephaly Potentially Associated with Zika Virus Infection During Pregnancy — Colombia, January–November 2016.
• Etiology of Microcephaly and Central Nervous System Defects during the Zika Epidemic in Colombia.external icon

Zika Outcomes and Development in Infants and Children (ZODIAC)

CDC collaborated with Brazil’s Ministry of Health to conduct a follow-up assessment of babies aged 12-24 months with congenital Zika virus infection in Brazil. The ZODIAC project sought to better understand the longer-term impacts of Zika virus infection on children infected before birth and their families. The project focused on physical growth, birth defects, vision, hearing, and the development of cognitive, social, language, and motor skills. ZODIAC also looked at how family functioning was affected by the baby’s Zika virus infection, and the care needs of the children and families. Data collection occurred from August-October 2017.

For more information, see:

• Health and Development at Age 19–24 Months of 19 Children Who Were Born with Microcephaly and Laboratory Evidence of Congenital Zika Virus Infection During the 2015 Zika Virus Outbreak — Brazil, 2017