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Zika virus infection during pregnancy

Last edited: 4/14/2026

Overview

Zika virus infection, primarily transmitted via Aedes mosquitoes, poses significant risks during pregnancy, including congenital malformations such as microcephaly and other neurological disorders 1819.

Diagnosis

  • Key Diagnostic Criteria: Symptomatic pregnant women with travel or sexual exposure to Zika-endemic areas 8.
  • Recommended Tests:
    • - Detection of viral RNA by molecular methods (RT-PCR) in blood, urine, saliva, and cerebrospinal fluid 10. - Serologic tests for ZIKV-specific IgM and IgG antibodies; confirmatory testing with plaque reduction neutralization test (PRNT) 10.
  • Grading: Testing should be performed regardless of symptoms in pregnant women with ongoing exposure 8.

    • Management

  • First-Line Management: Supportive care for symptoms; no specific antiviral treatment is currently available 815.
  • Adjunctive Measures:
    • - Monitoring for developmental milestones in infants born to infected mothers 19. - Prenatal care focusing on ultrasounds to detect fetal abnormalities 6.

    Special Populations

  • Pregnancy:
    • - Continuous monitoring and testing of pregnant women with potential exposure 810. - Coordination between obstetric and pediatric providers to ensure comprehensive care 6.
  • Pediatrics:
    • - Close follow-up for infants born to mothers with confirmed or possible Zika infection to assess for developmental delays and congenital anomalies 1915.

    Key Recommendations

  • Assess and Test Pregnant Women: Continuously assess pregnant women for potential Zika virus exposure and test symptomatic or exposed individuals, regardless of symptoms, for ZIKV infection (Evidence: Strong 8).
  • Enhance Provider Coordination: Improve communication and care coordination between obstetric and pediatric providers to address vertical transmission risks (Evidence: Moderate 6).
  • Public Health Surveillance: Implement robust surveillance systems to monitor socioeconomic and demographic factors influencing healthcare disparities during outbreaks (Evidence: Moderate 13).
  • Educational Outreach: Utilize obstetric practice websites and social media to disseminate accurate Zika virus information to pregnant women (Evidence: Moderate 16).
  • Ethical Considerations: Integrate ethical analysis into public health policy design to address inequalities and ensure equitable access to care during emergencies (Evidence: Moderate 12).

    • References

    1 Roy RR, Tadkalkar N, Deshpande GR, Atre NM, Shil P, Sapkal G. Identification of B-cell epitopes of Indian Zika virus strains using immunoinformatics. Frontiers in immunology 2025. link 2 Alharbi M, Alshammari A, Alsabhan JF, Alzarea SI, Alshammari T, Alasmari F et al.. A novel vaccine construct against Zika virus fever: insights from epitope-based vaccine discovery through molecular modeling and immunoinformatics approaches. Frontiers in immunology 2024. link 3 Viegas LL, Ventura DFL, Nunes J. A critical view of the global health emergencies: the 2016 zika epidemic case. Ciencia & saude coletiva 2022. link 4 Ventura D, Rached D, Martins J, Pereira C, Trivellato P, Guerra L. A rights-based approach to public health emergencies: The case of the 'More Rights, Less Zika' campaign in Brazil. Global public health 2021. link 5 Passos MJ, Matta G, Lyra TM, Moreira MEL, Kuper H, Penn-Kekana L et al.. The promise and pitfalls of social science research in an emergency: lessons from studying the Zika epidemic in Brazil, 2015-2016. BMJ global health 2020. link 6 Leeb RT, Cree RA, Aird L, DeBiasi RL, Driggers RW, Garbarczyk E et al.. A Framework for Coordination between Obstetric and Pediatric Providers in Public Health Emergencies: Lessons Learned from the Zika Outbreak in the United States, 2015 to 2017. American journal of perinatology 2020. link 7 Vannice KS, Giersing BK, Kaslow DC, Griffiths E, Meyer H, Barrett A et al.. Meeting Report: WHO consultation on considerations for regulatory expectations of Zika virus vaccines for use during an emergency. Vaccine 2019. link 8 . Management of Patients in the Context of Zika Virus: ACOG COMMITTEE OPINION, Number 784. Obstetrics and gynecology 2019. link 9 . Management of Patients in the Context of Zika Virus: ACOG COMMITTEE OPINION SUMMARY, Number 784. Obstetrics and gynecology 2019. link 10 Cordeiro MT. Laboratory diagnosis of Zika virus. Topics in magnetic resonance imaging : TMRI 2019. link 11 Bora K, Das D, Barman B, Borah P. Are internet videos useful sources of information during global public health emergencies? A case study of YouTube videos during the 2015-16 Zika virus pandemic. Pathogens and global health 2018. link 12 Jamrozik E, Selgelid MJ. Ethics, health policy, and Zika: From emergency to global epidemic?. Journal of medical ethics 2018. link 13 McQuade L, Rao M, Miller R, Zhou W, Deol R, Sato B. Understanding Patterns of Socioeconomic and Demographic Factors Along With Health Services Provider Availability for Zika Outbreak in South Florida. Disaster medicine and public health preparedness 2018. link 14 Sasmono RT, Dhenni R, Yohan B, Pronyk P, Hadinegoro SR, Soepardi EJ et al.. Zika Virus Seropositivity in 1-4-Year-Old Children, Indonesia, 2014. Emerging infectious diseases 2018. link 15 Blanco A, Chen L. Zika Virus: What Pediatric Emergency Medicine Physicians Need to Know. Pediatric emergency care 2017. link 16 Lehnert JD, Ellingson MK, Goryoka GW, Kasturi R, Maier E, Chamberlain AT. Use of Obstetric Practice Web Sites to Distribute Zika Virus Information to Pregnant Women During a Zika Virus Outbreak. Journal of public health management and practice : JPHMP 2017. link 17 Rao R, Gaw SL, Han CS, Platt LD, Silverman NS. Zika Risk and Pregnancy in Clinical Practice: Ongoing Experience as the Outbreak Evolves. Obstetrics and gynecology 2017. link 18 Singh VD, Lathrop SL. Role of the Medical Examiner in Zika Virus and Other Emerging Infections. Archives of pathology & laboratory medicine 2017. link 19 . Zika fever and congenital Zika syndrome: an unexpected emerging arboviral disease. British dental journal 2016. link 20 . Microcephaly and the Zika virus. Nursing children and young people 2016. link 21 Silveira FP, Campos SV. The Zika epidemics and transplantation. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2016. link

    Original source

    1. [1]
      Identification of B-cell epitopes of Indian Zika virus strains using immunoinformatics. — Roy RR, Tadkalkar N, Deshpande GR, Atre NM, Shil P, Sapkal G Frontiers in immunology (2025)
    2. [2]
      A novel vaccine construct against Zika virus fever: insights from epitope-based vaccine discovery through molecular modeling and immunoinformatics approaches. — Alharbi M, Alshammari A, Alsabhan JF, Alzarea SI, Alshammari T, Alasmari F et al. Frontiers in immunology (2024)
    3. [3]
      A critical view of the global health emergencies: the 2016 zika epidemic case. — Viegas LL, Ventura DFL, Nunes J Ciencia & saude coletiva (2022)
    4. [4]
      A rights-based approach to public health emergencies: The case of the 'More Rights, Less Zika' campaign in Brazil. — Ventura D, Rached D, Martins J, Pereira C, Trivellato P, Guerra L Global public health (2021)
    5. [5]
      The promise and pitfalls of social science research in an emergency: lessons from studying the Zika epidemic in Brazil, 2015-2016. — Passos MJ, Matta G, Lyra TM, Moreira MEL, Kuper H, Penn-Kekana L et al. BMJ global health (2020)
    6. [6]
      A Framework for Coordination between Obstetric and Pediatric Providers in Public Health Emergencies: Lessons Learned from the Zika Outbreak in the United States, 2015 to 2017. — Leeb RT, Cree RA, Aird L, DeBiasi RL, Driggers RW, Garbarczyk E et al. American journal of perinatology (2020)
    7. [7]
      Meeting Report: WHO consultation on considerations for regulatory expectations of Zika virus vaccines for use during an emergency. — Vannice KS, Giersing BK, Kaslow DC, Griffiths E, Meyer H, Barrett A et al. Vaccine (2019)
    8. [8]
      Management of Patients in the Context of Zika Virus: ACOG COMMITTEE OPINION, Number 784. Obstetrics and gynecology (2019)
    9. [9]
      Management of Patients in the Context of Zika Virus: ACOG COMMITTEE OPINION SUMMARY, Number 784. Obstetrics and gynecology (2019)
    10. [10]
      Laboratory diagnosis of Zika virus. — Cordeiro MT Topics in magnetic resonance imaging : TMRI (2019)
    11. [11]
      Are internet videos useful sources of information during global public health emergencies? A case study of YouTube videos during the 2015-16 Zika virus pandemic. — Bora K, Das D, Barman B, Borah P Pathogens and global health (2018)
    12. [12]
      Ethics, health policy, and Zika: From emergency to global epidemic? — Jamrozik E, Selgelid MJ Journal of medical ethics (2018)
    13. [13]
      Understanding Patterns of Socioeconomic and Demographic Factors Along With Health Services Provider Availability for Zika Outbreak in South Florida. — McQuade L, Rao M, Miller R, Zhou W, Deol R, Sato B Disaster medicine and public health preparedness (2018)
    14. [14]
      Zika Virus Seropositivity in 1-4-Year-Old Children, Indonesia, 2014. — Sasmono RT, Dhenni R, Yohan B, Pronyk P, Hadinegoro SR, Soepardi EJ et al. Emerging infectious diseases (2018)
    15. [15]
      Zika Virus: What Pediatric Emergency Medicine Physicians Need to Know. — Blanco A, Chen L Pediatric emergency care (2017)
    16. [16]
      Use of Obstetric Practice Web Sites to Distribute Zika Virus Information to Pregnant Women During a Zika Virus Outbreak. — Lehnert JD, Ellingson MK, Goryoka GW, Kasturi R, Maier E, Chamberlain AT Journal of public health management and practice : JPHMP (2017)
    17. [17]
      Zika Risk and Pregnancy in Clinical Practice: Ongoing Experience as the Outbreak Evolves. — Rao R, Gaw SL, Han CS, Platt LD, Silverman NS Obstetrics and gynecology (2017)
    18. [18]
      Role of the Medical Examiner in Zika Virus and Other Emerging Infections. — Singh VD, Lathrop SL Archives of pathology & laboratory medicine (2017)
    19. [19]
      Zika fever and congenital Zika syndrome: an unexpected emerging arboviral disease. British dental journal (2016)
    20. [20]
      Microcephaly and the Zika virus. Nursing children and young people (2016)
    21. [21]
      The Zika epidemics and transplantation. — Silveira FP, Campos SV The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (2016)
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