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Risk of adverse outcomes in offspring with RT-PCR confirmed prenatal Zika virus exposure: an individual participant data meta-analysis of 13 cohorts in the Zika Brazilian Cohorts Consortium

2022; Elsevier BV; Volume: 17; Linguagem: Inglês

10.1016/j.lana.2022.100395

2667-193X

Ricardo Arraes de Alencar Ximenes, Demócrito de Barros Miranda-Filho, Elizabeth B. Brickley, Thália Velho Barreto de Araújo, Ulísses Ramos Montarroyos, Marília Rosa Abtibol‐Bernardino, Marisa Márcia Mussi‐Pinhata, Geraldo Duarte, Conrado Milani Coutinho, Sílvia Fabiana Biason de Moura Negrini, Maria das Graças Costa Alecrim, Lucíola de Fátima Albuquerque de Almeida Peixoto, Maria Elisabeth Lopes Moreira, Andréa Zin, José Paulo Pereira Júnior, Karin Nielsen‐Saines, Celina Maria Turchi Martelli, Laura C. Rodrigues, Wayner Vieira de Souza, Liana O. Ventura, Consuelo Silva de Oliveira, Haroldo de Matos, E Serra, Luna Thais Souza Gomes, Maurício Lacerda Nogueira, Cássia Fernanda Estofolete, Denise Cristina Mós Vaz-Oliani, Saulo Duarte Passos, Antônio Fernandes Moron, Maria Manoela Duarte Rodrigues, Stéphanno Gomes Pereira Sarmento, Marília Dalva Turchi, Luiza Emylce Pelá Rosado, Ana Laura de Sene Amâncio Zara, Maria Bárbara Franco Gomes, Lavínia Schüler‐Faccini, Juliana Herrero-Silva, Melânia Maria Ramos Amorim, Adriana Oliveira Melo, Antônio José Lêdo Alves da Cunha, Arnaldo Prata‐Barbosa, Joffre Amim, Jorge Fonte de Rezende Filho, Juan Ignácio Calcagno, Luíz Carlos Júnior Alcântara, Breno Lima de Almeida, Cristina Barroso Hofer, Elizabeth S. Machado, Isadora Cristina de Siqueira, Flor Ernestina Martínez-Espinosa, Patrícia Brasil, Mariana de Carvalho Leal Gouveia, Maria de Fátima Pessoa Militão de Albuquerque, Jociele Malacarne, Luana Damasceno, Ana María Bispo de Filippis, Cleiton Silva Santos, Alan Oliveira Duarte, Pedro Fernando da Costa Vasconcelos, Mariana Borges Machado, Ana Paula Antunes Pascalicchio Bertozzi, Thamirys Cosmo Gillo Fajardo, Adriana Aparecida Tiraboschi Bárbaro, Ligia Conceição Marçal Assef, Clarice Pimentel, Thalita Fernandes de Abreu, Jousilene de Sales Tavares, Fabiana de Oliveira Melo, Talita de Toledo Lima, Maria das Graças Nunes Brasil, Cláudia Pereira Terças-Trettel, Giovanny Vinícius de Araújo França, Camila Bôtto-Menezes, Silvana Gomes Benzecry, Jaqueline Rodrigues Robaina, Mariana Barros Genuíno de Oliveira,

Viral Infections and Vectors

Knowledge regarding the risks associated with Zika virus (ZIKV) infections in pregnancy has relied on individual studies with relatively small sample sizes and variable risk estimates of adverse outcomes, or on surveillance or routinely collected data. Using data from the Zika Brazilian Cohorts Consortium, this study aims, to estimate the risk of adverse outcomes among offspring of women with RT-PCR-confirmed ZIKV infection during pregnancy and to explore heterogeneity between studies.We performed an individual participant data meta-analysis of the offspring of 1548 pregnant women from 13 studies, using one and two-stage meta-analyses to estimate the absolute risks.Of the 1548 ZIKV-exposed pregnancies, the risk of miscarriage was 0.9%, while the risk of stillbirth was 0.3%. Among the pregnancies with liveborn children, the risk of prematurity was 10,5%, the risk of low birth weight was 7.7, and the risk of small for gestational age (SGA) was 16.2%. For other abnormalities, the absolute risks were: 2.6% for microcephaly at birth or first evaluation, 4.0% for microcephaly at any time during follow-up, 7.9% for neuroimaging abnormalities, 18.7% for functional neurological abnormalities, 4.0% for ophthalmic abnormalities, 6.4% for auditory abnormalities, 0.6% for arthrogryposis, and 1.5% for dysphagia. This risk was similar in all sites studied and in different socioeconomic conditions, indicating that there are not likely to be other factors modifying this association.This study based on prospectively collected data generates the most robust evidence to date on the risks of congenital ZIKV infections over the early life course. Overall, approximately one-third of liveborn children with prenatal ZIKV exposure presented with at least one abnormality compatible with congenital infection, while the risk to present with at least two abnormalities in combination was less than 1.0%.