Population-based surveillance for birth defects potentially related to Zika virus infection including 3-year mortality and developmental outcomes, and Early Intervention Program service use-New York City, 2016 birth cohort
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Katharine H McVeigh1, Tenzin Tseyang1, Mary-Elizabeth Vachon1
1Division of Family and Child Health, New York City Department of Health and Mental Hygiene, Queens, New York, USA.
Insights
New York City infants born in 2016 showed a low prevalence of birth defects potentially linked to Zika virus. Early Intervention Program referrals varied by maternal marital status and origin.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- The 2015-2017 Zika virus outbreak prompted New York City (NYC) to monitor infants for potential congenital Zika virus-related birth defects.
- This initiative aimed to identify and track infants exhibiting symptoms associated with the virus.
Purpose of the Study:
- To characterize birth defects potentially related to congenital Zika virus infection in NYC infants born in 2016.
- To compare these infants with the general NYC birth population.
- To monitor mortality and Early Intervention Program (EIP) utilization up to age 2.
Main Methods:
- Utilized administrative data matching to identify infants meeting screening criteria for Zika-related birth defects.
- Analyzed birth characteristics, mortality data, and EIP referral rates.
- Compared outcomes for infants meeting the Centers for Disease Control and Prevention (CDC) case definition with non-cases and the general birth cohort.
Main Results:
- Out of 120,367 infants born in 2016, 463 met screening criteria, and 155 met the CDC case definition (1.3 per 1000 births).
- Post-neonatal mortality was 7.7% for cases and 5.2% for non-cases.
- Lower odds of EIP referral were observed for children of married mothers and for non-cases whose mothers were from Latin America and the Caribbean.
Conclusions:
- The prevalence of birth defects potentially linked to congenital Zika virus in NYC was comparable to regions without local transmission.
- Congenital Zika virus infection may have been present in screened infants who did not meet the formal case definition.
Background:
In response to the 2015-2017 Zika virus outbreak, New York City (NYC) identified and monitored infants with birth defects potentially related to congenital Zika virus.
Methods:
Administrative data matches were used to describe the birth characteristics of children born in 2016 meeting screening criteria for birth defects potentially related to congenital Zika virus infection relative to other NYC births and to monitor mortality and Early Intervention Program use through age 2.
Results:
Among 120,367 children born in NYC in 2016, 463 met screening criteria and 155 met the Centers for Disease Control and Prevention's case definition for birth defects potentially related to congenital Zika virus infection (1.3 per 1000; 95% confidence interval [CI], 1.1-1.5). Post-neonatal deaths occurred among 7.7% of cases (12) and 5.2% of non-cases (8). Odds of referral to the Early intervention Program among children who met screening criteria were lower among children of mothers who were married (OR, 0.60; 95% CI, 0.37-0.97) and among children not classified as cases whose mothers were born in Latin America and the Caribbean (OR, 0.59; 95% CI, 0.37-1.09).
Discussion:
Prevalence of birth defects potentially related to congenital Zika virus infection was similar to that seen in other jurisdictions without local transmission. Birth defects attributable to congenital Zika virus infection may also have been present among screened children who did not meet the case definition.
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