Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro

This retrospective cohort study analyzed 7870 pregnant women, including 2269 with confirmed Zika virus (ZIKV) infection and 5601 without Zika infection, along with their fetuses and newborns. Data were sourced from multiple databases in the state of Rio de Janeiro, Brazil. A propensity score model w...

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Main Authors: Marlos Melo Martins, Roberto de Andrade Medronho, Carlos Eduardo Raymundo, Arnaldo Prata-Barbosa, Antonio José Ledo Alves da Cunha
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/17/2/208
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author Marlos Melo Martins
Roberto de Andrade Medronho
Carlos Eduardo Raymundo
Arnaldo Prata-Barbosa
Antonio José Ledo Alves da Cunha
author_facet Marlos Melo Martins
Roberto de Andrade Medronho
Carlos Eduardo Raymundo
Arnaldo Prata-Barbosa
Antonio José Ledo Alves da Cunha
author_sort Marlos Melo Martins
collection DOAJ
description This retrospective cohort study analyzed 7870 pregnant women, including 2269 with confirmed Zika virus (ZIKV) infection and 5601 without Zika infection, along with their fetuses and newborns. Data were sourced from multiple databases in the state of Rio de Janeiro, Brazil. A propensity score model was employed to control confounding factors and stratify outcomes by pregnancy trimester. Among ZIKV+ pregnant women, 49 cases of congenital microcephaly or congenital nervous system (CNS) abnormalities were identified (2.16%, or 193.9 cases in 10,000 live births), whereas 44 cases were identified among ZIKV− women (0.78%, or 71.4 cases in 10,000 live births). Multivariable analysis yielded an odds ratio of 2.46 (95% CI 1.30–4.64) overall, with 4.29 (95% CI 1.93–9.53) in the first trimester, 5.29 (95% CI 1.08–25.95) in the second trimester, and 0.68 (95% CI 0.21–2.14) in the third trimester. The most frequent findings among ZIKV+ cases included intracranial calcifications, ventriculomegaly, posterior fossa malformations, reduced brain volume, corpus callosum malformations, cortex dysplasia, lissencephaly, and pachygyria. Ophthalmologic abnormalities were detected in 55.5% of cases, and brainstem auditory evoked potential anomalies were reported in 33.3%. ZIKV infection can result in structural or functional anomalies. Given the absence of specific treatment for congenital Zika syndrome (CZS), clinical care should prioritize monitoring and managing neurological, motor, auditory, visual, and orthopedic disorders in all children with in utero ZIKV exposure, especially during the first and second trimesters of pregnancy.
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spelling doaj-art-a96747e2331742ceb2c036f14420ed1e2025-08-20T02:03:32ZengMDPI AGViruses1999-49152025-01-0117220810.3390/v17020208Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de JaneiroMarlos Melo Martins0Roberto de Andrade Medronho1Carlos Eduardo Raymundo2Arnaldo Prata-Barbosa3Antonio José Ledo Alves da Cunha4Division of Pediatric Neurology, Martagão Gesteira Institute of Childcare and Pediatrics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, BrazilDepartment of Epidemiology and Public Health, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-592, BrazilDepartment of Epidemiology and Public Health, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-592, BrazilDepartment of Pediatrics, D’Or Institute for Research and Education (IDOR), Rio de Janeiro 2281-100, BrazilDepartment of Pediatrics, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21044-020, BrazilThis retrospective cohort study analyzed 7870 pregnant women, including 2269 with confirmed Zika virus (ZIKV) infection and 5601 without Zika infection, along with their fetuses and newborns. Data were sourced from multiple databases in the state of Rio de Janeiro, Brazil. A propensity score model was employed to control confounding factors and stratify outcomes by pregnancy trimester. Among ZIKV+ pregnant women, 49 cases of congenital microcephaly or congenital nervous system (CNS) abnormalities were identified (2.16%, or 193.9 cases in 10,000 live births), whereas 44 cases were identified among ZIKV− women (0.78%, or 71.4 cases in 10,000 live births). Multivariable analysis yielded an odds ratio of 2.46 (95% CI 1.30–4.64) overall, with 4.29 (95% CI 1.93–9.53) in the first trimester, 5.29 (95% CI 1.08–25.95) in the second trimester, and 0.68 (95% CI 0.21–2.14) in the third trimester. The most frequent findings among ZIKV+ cases included intracranial calcifications, ventriculomegaly, posterior fossa malformations, reduced brain volume, corpus callosum malformations, cortex dysplasia, lissencephaly, and pachygyria. Ophthalmologic abnormalities were detected in 55.5% of cases, and brainstem auditory evoked potential anomalies were reported in 33.3%. ZIKV infection can result in structural or functional anomalies. Given the absence of specific treatment for congenital Zika syndrome (CZS), clinical care should prioritize monitoring and managing neurological, motor, auditory, visual, and orthopedic disorders in all children with in utero ZIKV exposure, especially during the first and second trimesters of pregnancy.https://www.mdpi.com/1999-4915/17/2/208Zika virusmicrocephalyCNS congenital malformations
spellingShingle Marlos Melo Martins
Roberto de Andrade Medronho
Carlos Eduardo Raymundo
Arnaldo Prata-Barbosa
Antonio José Ledo Alves da Cunha
Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro
Viruses
Zika virus
microcephaly
CNS congenital malformations
title Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro
title_full Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro
title_fullStr Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro
title_full_unstemmed Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro
title_short Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro
title_sort neonatal microcephaly and central nervous system abnormalities during the zika outbreak in rio de janeiro
topic Zika virus
microcephaly
CNS congenital malformations
url https://www.mdpi.com/1999-4915/17/2/208
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