VP23.04: Maternal infection and adverse pregnancy outcomes among pregnant travellers: results of the international Zika virus in pregnancy registry
Bibliographic record
Abstract
Though the risk of adverse pregnancy outcomes among patients living in areas with Zika virus (ZIKV) circulation is well documented, the risk for travellers remains poorly described. In this 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. This multicentre cohort study recruited pregnant women exposed to ZIKV at any stage during gestation either by living in or by travelling to areas with active ZIKV circulation. A total of 144 pregnant travellers and 721 pregnant women living in areas with ZIKV circulation were included. The risk of maternal infection was lower among pregnant travellers compared to pregnant women living in areas with ZIKV areas (25.0% (n = 36/144) versus 42.9% (n = 309/721), RD -17.9% 95%CI -25.8%—9.9%; crude RR 0.6, 95%CI 0.4 – 0.8; P value < 0.001; aRR 0.6;95%CI 0.5-0.8; P value < 0.001). In a nested case-control study, risk factors associated with maternal infections among travellers were travelling during the epidemic period (aOR 29.4 95%CI 3.7-228.1, P value 0.001), travelling to the Caribbean Islands (aOR 3.2 95%CI 1.2-8.7, P value 0.023) and stays > 2 weeks (aOR 8.7; 95%CI 1.1-71.5, P value 0.041). The prevalence of severe adverse pregnancy outcomes within the cohort was (7.8%; n = 67). The risk did not differ among infected travellers and infected women living in areas with ZIKV circulation (8.3%(n = 3/36) versus 12.67% (n = 39/309); RD 4.3%, 95% CI -14.1-5.5; crude RR 0.7 95%CI 0.2-2.0, P value 0.5961; aRR 0.7 95%CI 0.2-2.1, P value 0.485). The risk of maternal infections seems low in the absence of ongoing outbreaks and in case of short stays (< 2 weeks). In case of a confirmed maternal infection, the majority of fetuses will remain pauci-symptomatic. Pregnant women and couples trying to conceive should therefore be reassured and international travelling recommendations adapted accordingly.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".