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Title: The Zika Virus and Congenital Birth Defects: An Investigation into the Role of the Placenta and the Time of Infection
Authors: Reeves, Hailey
Advisors: Metcalf, C. Jessica E.
Department: Ecology and Evolutionary Biology
Class Year: 2017
Abstract: After many years of intermittent individual infections, in the past four years the Zikavirus (ZIKV) has spread rapidly. An increase in the frequency of cases of congenital neurologicalabnormalities, such as microcephaly, has been observed in conjunction with the rise of ZIKV. Asof April 21st, 2016, the World Health Organization (WHO) determined congenital infection withthe Zika virus can cause microcephaly.^4 This investigation will look to amalgamate the clinical, laboratory, and morphological information of 33 mothers who were infected with the Zika virus during pregnancy in Rio de Janeiro, Brazil in 2015-2016. First, we explore the influence of time of infection on the presence and severity of malformations in newborns. Second, we evaluate morphological features of the placentas in order to determine if Zika causes structural damage to the placenta, and if so, if these features can be used as a diagnostic tool in the future. To our knowledge, this is the first investigation of its kind which analyzes more than a few placentas. Finally, we compare the morphological features of ZIKV infected placentas to the placental abnormalities produced by TORCH pathogens. We found the time of infection played a significant role in the incidence of microcephalyand other CNS alterations in fetuses. The majority of children who presented with adverseclinical outcomes were noted during the first trimester (60%), with 6 of 7 (86%) cases in thistrimester presenting with microcephaly and/or other CNS alterations. Two cases of secondtrimester infection resulting in malformations were noted, while no cases of third trimesterinfection resulted in CNS alterations. While evaluating the placentas, the most commonmorphological changes were fibrosis of the stroma (97%) and villitis scarring (94%). Several ofthe placental alterations observed were consistent with structural changes seen in placentasinfected with TORCH pathogens. These results provide new cases and information toresearchers who are currently working on a vaccine for the Zika virus. In light of ourobservations, it is likely the placenta could be used as a diagnostic tool in the future, howevermore research is needed to confirm this. As the placental alterations due to congenital ZIKV infection continue to be investigated, our study will serve as preliminary evidence to suggestthat congenital Zika infection can cause morphological abnormalities in the placenta.
Type of Material: Princeton University Senior Theses
Language: en_US
Appears in Collections:Ecology and Evolutionary Biology, 1992-2020

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