Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients

ABSTRACT Objective: To explore the association between the Zika virus epidemic, fertility rates, and sociodemographic and behavioral factors influencing birth trends. Methods: A prospective cohort of 1,497 women aged between 15 and 39 years living in arbovirus-endemic areas in Fortaleza, Brazil,...

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Main Authors: Carlos Sanhueza-Sanzana, Carl Kendall, Kasim Allel, Moisés Humberto Sandoval González, Rosa Livia Freitas de Almeida, Italo Wesley Oliveira Aguiar, Lívia Karla Sales Dias, Roberto Justa da Pires Neto, Cristiane Cunha Frota, Francisco Gustavo Silveira Correia, Francisco Herlânio Costa Carvalho, Ivana Cristina de Holanda Cunha Barreto, Marto Leal, Anya Pimentel Gomes Fernandes Vieira-Meyer, George Rutherford, Ligia Kerr
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Language:English
Published: Associação Brasileira de Pós-Graduação em Saúde Coletiva 2025-08-01
Series:Revista Brasileira de Epidemiologia
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2025000100435&tlng=en
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author Carlos Sanhueza-Sanzana
Carl Kendall
Kasim Allel
Moisés Humberto Sandoval González
Rosa Livia Freitas de Almeida
Italo Wesley Oliveira Aguiar
Lívia Karla Sales Dias
Roberto Justa da Pires Neto
Cristiane Cunha Frota
Francisco Gustavo Silveira Correia
Francisco Herlânio Costa Carvalho
Ivana Cristina de Holanda Cunha Barreto
Marto Leal
Anya Pimentel Gomes Fernandes Vieira-Meyer
George Rutherford
Ligia Kerr
author_facet Carlos Sanhueza-Sanzana
Carl Kendall
Kasim Allel
Moisés Humberto Sandoval González
Rosa Livia Freitas de Almeida
Italo Wesley Oliveira Aguiar
Lívia Karla Sales Dias
Roberto Justa da Pires Neto
Cristiane Cunha Frota
Francisco Gustavo Silveira Correia
Francisco Herlânio Costa Carvalho
Ivana Cristina de Holanda Cunha Barreto
Marto Leal
Anya Pimentel Gomes Fernandes Vieira-Meyer
George Rutherford
Ligia Kerr
author_sort Carlos Sanhueza-Sanzana
collection DOAJ
description ABSTRACT Objective: To explore the association between the Zika virus epidemic, fertility rates, and sociodemographic and behavioral factors influencing birth trends. Methods: A prospective cohort of 1,497 women aged between 15 and 39 years living in arbovirus-endemic areas in Fortaleza, Brazil, was analyzed. Women were enrolled in February 2018 and followed up two times every six months. The total fertility rate (TFR), age-specific fertility rate (ASFR), and mean age at first birth (MAB) were estimated and a multivariate Poisson regression model was used to explore the main factors associated with fertility. Results: The TFR was lowest during the epidemic period (2.64, 95%CI 2.06-3.06), increasing in the post-epidemic phase (TFR=3.52, 95%CI 3.18-3.86). Low educational attainment (RR=1.32, TFR=3.69, 95%CI 3.26-4.13), overcrowding (RR=1.27, TFR=3.26, 95%CI 2.98-3.54), and having undergone an abortion (RR=1.85, TFR=4.88, 95%CI 4.31-5.45) were associated with higher fertility rates. Conversely, having had an unwanted pregnancy was associated with reduced fertility (RR=0.81, TFR=2.65, 95%CI 2.41-2.89). Conclusion: We observed a slowdown in fertility rates during the epidemic period coincident with human Zika virus transmission with large differences by sociodemographic gradients.
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spelling doaj-art-964713788b2040fdbc18d56b4c654e752025-08-20T03:41:22ZengAssociação Brasileira de Pós-Graduação em Saúde ColetivaRevista Brasileira de Epidemiologia1980-54972025-08-012810.1590/1980-549720250044Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradientsCarlos Sanhueza-Sanzanahttps://orcid.org/0000-0002-6021-564XCarl Kendallhttps://orcid.org/0000-0002-0794-4333Kasim Allelhttps://orcid.org/0000-0002-2144-7181Moisés Humberto Sandoval Gonzálezhttps://orcid.org/0000-0003-0112-2045Rosa Livia Freitas de Almeidahttps://orcid.org/0000-0001-6423-543XItalo Wesley Oliveira Aguiarhttps://orcid.org/0000-0002-7743-3109Lívia Karla Sales Diashttps://orcid.org/0000-0002-3000-1472Roberto Justa da Pires Netohttps://orcid.org/0000-0003-0291-9523Cristiane Cunha Frotahttps://orcid.org/0000-0003-0018-7736Francisco Gustavo Silveira Correiahttps://orcid.org/0000-0002-5043-6393Francisco Herlânio Costa Carvalhohttps://orcid.org/0000-0002-6400-4479Ivana Cristina de Holanda Cunha Barretohttps://orcid.org/0000-0001-8447-3654Marto Lealhttps://orcid.org/0000-0003-4318-552XAnya Pimentel Gomes Fernandes Vieira-Meyerhttps://orcid.org/0000-0003-4237-8995George Rutherfordhttps://orcid.org/0000-0001-9747-4402Ligia Kerrhttps://orcid.org/0000-0003-4941-408XABSTRACT Objective: To explore the association between the Zika virus epidemic, fertility rates, and sociodemographic and behavioral factors influencing birth trends. Methods: A prospective cohort of 1,497 women aged between 15 and 39 years living in arbovirus-endemic areas in Fortaleza, Brazil, was analyzed. Women were enrolled in February 2018 and followed up two times every six months. The total fertility rate (TFR), age-specific fertility rate (ASFR), and mean age at first birth (MAB) were estimated and a multivariate Poisson regression model was used to explore the main factors associated with fertility. Results: The TFR was lowest during the epidemic period (2.64, 95%CI 2.06-3.06), increasing in the post-epidemic phase (TFR=3.52, 95%CI 3.18-3.86). Low educational attainment (RR=1.32, TFR=3.69, 95%CI 3.26-4.13), overcrowding (RR=1.27, TFR=3.26, 95%CI 2.98-3.54), and having undergone an abortion (RR=1.85, TFR=4.88, 95%CI 4.31-5.45) were associated with higher fertility rates. Conversely, having had an unwanted pregnancy was associated with reduced fertility (RR=0.81, TFR=2.65, 95%CI 2.41-2.89). Conclusion: We observed a slowdown in fertility rates during the epidemic period coincident with human Zika virus transmission with large differences by sociodemographic gradients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2025000100435&tlng=enZika virus infectionFertilityCongenital zika syndromeHealth status disparitiesBrazil
spellingShingle Carlos Sanhueza-Sanzana
Carl Kendall
Kasim Allel
Moisés Humberto Sandoval González
Rosa Livia Freitas de Almeida
Italo Wesley Oliveira Aguiar
Lívia Karla Sales Dias
Roberto Justa da Pires Neto
Cristiane Cunha Frota
Francisco Gustavo Silveira Correia
Francisco Herlânio Costa Carvalho
Ivana Cristina de Holanda Cunha Barreto
Marto Leal
Anya Pimentel Gomes Fernandes Vieira-Meyer
George Rutherford
Ligia Kerr
Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients
Revista Brasileira de Epidemiologia
Zika virus infection
Fertility
Congenital zika syndrome
Health status disparities
Brazil
title Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients
title_full Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients
title_fullStr Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients
title_full_unstemmed Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients
title_short Exploring the Zika virus epidemic’s association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients
title_sort exploring the zika virus epidemic s association with fertility in a cohort of women of northeastern brazil socioeconomic and educational gradients
topic Zika virus infection
Fertility
Congenital zika syndrome
Health status disparities
Brazil
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2025000100435&tlng=en
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