[music] dr. catherine y. spong: so in general,when we see these viral infections, an impact in the first trimester is going to be the most severe. now that may be the case in zika. we're still waiting for data to tell us that. but there has been data that's come out that has shown that, even infection in the third trimester, which is a timeperiod after the majority of
organogenesis has occurred,so the organs forming has occurred, can have a significant impact. so it's very concerningwhat this virus can do during pregnancy and reallyunderstanding it is going to be absolutely essential. we need to be able to tell a woman andtell a family, what is the risk of having zika virus on pregnancy, andwe need to be able to tell her that given the constellation of pregnancyitself, so if she is in her first trimester, if she is under 13 weeks, howis that different than if she is 20 weeks,
or if she is 25 weeks? does it matter if she's had some other co-infection? does it matter if she was symptomatic with the virus, meaning she had the rash or the fever, or if she was asymptomatic with the virus? does that change the impact forthe pregnancy itself? does it matter howthe virus was obtained, whether it was sexually transmitted or from a mosquito?and then, what are the roles of these other environmental factors? so isthe environment that she's living going to make the infection with zika worse for her pregnancy itself?
what we know now are really just for those women who have had a symptomatic infection, and for the most part, have had a child who's had microcephaly, or a small head, and it's going to require a lot ofunderstanding of, what are the implications of that, because microcephaly itself can have quite a spectrum of outcomes. and the outcome of microcephaly due to zika virus is not yet told. we don't know exactly what that's going to look like,
so we are going to need to study and understand, what is the impact of microcephaly from zika virus,and what are the interventions that might optimize those outcomes. but it goes actually even beyond that, because there are going to bechildren born who don't have microcephaly, but still havecomplications likely from zika virus, and so it's important, as we do these studies, to follow not only the children who have microcephaly, but to follow all of the children, and to really systematically understand, what is impacted from zika virus, and then whatinterventions can we do
to try to optimize their outcome.
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