The World Health Organization said on June 10 that its guidance about pregnancy in Zika-affected areas had been misinterpreted; the agency is not advising women to consider delaying pregnancy. Learn more about the WHO’s response here.
The World Health Organization appears to be trying to steer women toward delaying pregnancy if they live in countries where the Zika virus is spreading.
The global health organization had previously avoided issuing that type of advice, suggesting women in Zika-affected countries speak to their doctors about the issue. But in its most recent guidance, the Geneva-based agency has suggested that people of reproductive age living in affected areas “be informed and orientated to consider delaying pregnancy.”
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In January, El Salvador made headlines around the globe when its deputy health minister urged women to hold off getting pregnant for the next two years. Most other governments have refrained from going that far, suggesting the decision to try to become pregnant is a personal one.
The guidance from the Centers for Disease Control and Prevention, for instance, notes pregnancy involves “very complex, deeply personal decisions” and advises doctors to talk to women and their partners about pregnancy planning and strategies to avoid unintended pregnancies.
“As part of their pregnancy planning and counseling with their health care providers, some women and their partners residing in areas with active Zika virus transmission might decide to delay pregnancy,” the agency said Thursday in a brief statement about the WHO’s revised position.
The WHO systematically reviews new evidence and revises its advice as needed, spokeswoman Nyka Alexander told STAT by email.
Expert meetings were held in mid-March, she said. “These updates are a result of those meetings and further input from experts in the editing process.”
Alexander stressed the importance of the way the advice is worded: “It is a matter of ensuring people are given information about delay as an option for them to consider.”
The revised guidance was published online on May 30, Alexander said. The press release issued at the time did not flag the change.
Infectious diseases expert Michael Osterholm said it makes sense for people living in places where Zika is spreading to delay pregnancy, if they can.
Osterholm, the director of the University of Minnesota’s Center for Infectious Diseases Research and Policy, said while the risk from Zika is high now, it will likely subside. If the pattern of spread of related diseases can be used to predict what will happen with Zika, this period of explosive transmission will ebb in a year or two.
“We’re going to see this likely peak in the next 12 to 18 months in terms of the number of new infections. And then as more people become infected, and recover, the transmission dynamics will drop,” he said.
But Lawrence Gostin, a professor of global health law at Georgetown University, was not so sure the WHO’s revised guidance will help women living in Zika-affected places.
“The problem with suggesting that women postpone pregnancy is that many Latin-American countries have the most restrictive contraception and abortion laws in the world. Even though WHO recommended access to emergency contraception, there is literally no assurance that governments would comply,” Gostin said.
Some babies born to mothers infected with Zika have been found to have a host of birth defects, including microcephaly, a condition in which newborns have abnormally small heads.
Studies have suggested that 1 in 100 women infected in pregnancy might have a child with microcephaly — though one paper said the figure might be as high as 13 percent.
Other studies have suggested microcephaly is the tip of the iceberg when it comes to Zika-related birth defects. Some babies that were infected in the womb are born with visual and hearing impairments; others have other forms of brain damage.