Study Population
Every pregnant woman who contacted a health facility with
Flavivirus-like symptoms and were reported to the local Disease Control
Division (DCD) and had blood (within 5 days of symptoms) and urine
(within 8 days) taken for RNA-ZIKV17 testing by Adolfo
Lutz Institute. ZIKV infection was confirmed in women if there
was detectable ZIKV-RNA in blood, urine, amniotic fluid, or
feto-placental tissue after pregnancy loss.
Most patients received prenatal care and delivered in various
institutions without knowing their ZIKV-RNA status, as the sudden
pandemic meant that demands on the single reference laboratory was very
high, leading to delay in results (median 39 days). A taskforce (NATZIG
study team, Ribeirão Preto DCD, and the São Paulo State Secretary of
Health) contacted all mothers and obtain pregnancy, delivery, and
neonatal information from medical records, their family physicians and
directly from patients.