Identifying possible inaccuracy in reported birth head circumference measurements among infants in the US Zika Pregnancy and Infant Registry

Details

• Alternative Title:
  Birth Defects Res
• Personal Author:
  Roth, Nicole M. ; Woodworth, Kate R. ; Godfred-Cato, Shana ; Delaney, Augustina M. ; Olson, Samantha M. ; Nahabedian, John F. ; Reynolds, Megan R. ; Jones, Abbey M. ; Neelam, Varsha ; Valencia-Prado, Miguel ; Delgado-López, Camille ; Lee, Ellen H. ; Ellis, Esther M. ; Lake-Burger, Heather ; Tonzel, Julius L. ; Higgins, Cathleen A. ; Chan, Ronna L. ; Tong, Van T. ; Gilboa, Suzanne M. ; Cragan, Janet D. ; Honein, Margaret A. ; Moore, Cynthia A.
• Description:
  Background:
  
  The US Zika Pregnancy and Infant Registry (USZPIR) monitors infants born to mothers with confirmed or possible Zika virus infection during pregnancy. The surveillance case definition for Zika-associated birth defects includes microcephaly based on head circumference (HC).
  
  Methods:
  
  We assessed birth and follow-up data from infants with birth HC measurements <3rd percentile and birthweight ≥10th percentile to determine possible misclassification of microcephaly. We developed a schema informed by literature review and expert opinion to identify possible HC measurement inaccuracy using HC growth velocity and longitudinal HC measurements between 2 and 12 months of age. Two or more HC measurements were required for assessment. Inaccuracy in birth HC measurement was suspected if growth velocity was >3 cm/month in the first 3 months or HC was consistently >25th percentile during follow-up.
  
  Results:
  
  Of 6,799 liveborn infants in USZPIR, 351 (5.2%) had Zika-associated birth defects, of which 111 had birth HC measurements <3rd percentile and birthweight ≥10th percentile. Of 84/111 infants with sufficient follow-up, 38/84 (45%) were classified as having possible inaccuracy of birth HC measurement, 19/84 (23%) had HC ≥3rd percentile on follow-up without meeting criteria for possible inaccuracy, and 27/84 (32%) had continued HC <3rd percentile. After excluding possible inaccuracies, the proportion of infants with Zika-associated birth defects including microcephaly decreased from 5.2% to 4.6%.
  
  Conclusions:
  
  About one-third of infants in USZPIR with Zika-associated birth defects had only microcephaly, but indications of possible measurement inaccuracy were common. Implementation of this schema in longitudinal studies can reduce misclassification of microcephaly.
  
  
• Subjects:
  Birth Weight Female Humans Infant Male Microcephaly Pregnancy Pregnancy Complications, Infectious Registries Zika Virus Zika Virus Infection

  More +
• Source:
  Birth Defects Res. 114(8):314-318
• Pubmed ID:
  35332688
• Pubmed Central ID:
  PMC10391875
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Place as Subject:
  United States
• Volume:
  114
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d6bd598a8af2a773c4742581eca6e8eae9b5a6d80b68ecc466479b985e08dc0f
• Download URL:
  https://stacks.cdc.gov/view/cdc/131550/cdc_131550_DS1.pdf
• File Type:
  [PDF - 135.45 KB ]