The World Health Organization defines current outbreak of Zika infection as a Public Health Emergency of International Concern (PHEIC). An attempt was made to contribute in a comprehensive screening protocol for ZIKV in pregnancy, based on systematic assessment of the empirical data. A total of 34 published articles, conferring to the level I-IIA evidence, are randomly identified to inform clinical, immunology, imaging, and patho-histology findings from 8,389 singleton pregnancies. Results of a comparative analysis between the Zika-positive and Zikanegative pregnant women presented with macopapular rash suggest that active Zika virus infection is predictive to the adverse perinatal outcomes: prematurity, fetal growth restriction, microcephaly, and Guillain-Barré syndrome. Temporal analysis between the viral peak lags, the first acute rash in women, and perinatal outcomes, support such associations. Clinical (observational) data include: miscarriage, stillbirth, fetal growth restriction (FGR), oligohydramnios, preeclampsia, preterm birth, small for gestational age (SGA) newborns, placentation defects (premature detachment, accreta, increta, percreta), neonatal conjunctivitis, neonatal pneumonia, microcephaly, splenomegaly, Guillain-Barré syndrome, congenital birth defects, and perinatal death. Serology data are generated from the reported results of reverse transcriptionpolymerase chain reaction (RT-PCR), immunoglobulin M (IgM) quantitative testing, and enzyme-linked immunosorbent assay (ELISA). Imaging data include the results of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) from the abdominal, thoracic, and cranial screening of the newborns. Pathological data include placental histology and neonatal autopsy results. 

Frequencies and means extracted from the studies are combined to present weighted mean difference statistic and are modeled as measurable outcomes. Odds of numerical variables (biparietal diameter [BPD], femur length [FL], occipito-mental diameter [OMD], occipito-frontal diameter [OFD], sub-occipito-bregmatic diameter [SOBD], sub-mentobregmatic diameter [SMBD], amniotic fluid index [AFI], Apgar scores) are used as linear functions exposed to the factors. Temporal correlations and time lags are tested to distinguish the primary and recurrent infections, also to identify the proximity between the epidemic curves and reported clinical and parametric outcomes.

With Regards,
Sara Giselle
Associate Managing Editor    
Journal of Critical Care Obsestrics & Gynocology