Congenital Zika Syndrome: Prevalence of low birth weight and associated factors. Bahia, 2015–2017

Carvalho-Sauer, Rita de Cássia Oliveira de; Costa, Maria da Conceição Nascimento; Barreto, Florisneide Rodrigues; Teixeira, Maria da Glória Lima Cruz

doi:10.1016/j.ijid.2019.02.040

Cited by 24 publications

(23 citation statements)

References 16 publications

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“…Body weight reduction is a clear sign of intrauterine growth restriction, a condition that was described as part of CZS in humans (7,34,35) and mouse models (5,6). Recently, a survey showed that the prevalence of low birth weight is four times higher in CZS children compared to other newborns from the same region (36). In our assays, we found body weight reduction in infected malnourished litters, consistent with the findings in human CZS cases.…”

Section: Discussionsupporting

confidence: 91%

Congenital Zika syndrome is associated with maternal protein malnutrition

et al. 2020

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Zika virus (ZIKV) infection during pregnancy is associated with a spectrum of developmental impairments known as congenital Zika syndrome (CZS). The prevalence of this syndrome varies across ZIKV endemic regions, suggesting that its occurrence could depend on cofactors. Here, we evaluate the relevance of protein malnutrition for the emergence of CZS. Epidemiological data from the ZIKV outbreak in the Americas suggest a relationship between undernutrition and cases of microcephaly. To experimentally examine this relationship, we use immunocompetent pregnant mice, which were subjected to protein malnutrition and infected with a Brazilian ZIKV strain. We found that the combination of protein restriction and ZIKV infection leads to severe alterations of placental structure and embryonic body growth, with offspring displaying a reduction in neurogenesis and postnatal brain size. RNA-seq analysis reveals gene expression deregulation required for brain development in infected low-protein progeny. These results suggest that maternal protein malnutrition increases susceptibility to CZS.

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Section: Discussionsupporting

confidence: 91%

Congenital Zika syndrome is associated with maternal protein malnutrition

et al. 2020

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“…Low birthweight and intrauterine growth restriction were common findings in the studies in the current review [19,63,64,69,82,85,[89][90][91], representing a risk for children exposed to ZIKV during pregnancy. A recent study found that prevalence of Low birthweight in infants with CZS was more than four times that of the overall sample of live births [144].…”

Section: Plos Onementioning

confidence: 96%

Congenital Zika syndrome: A systematic review

et al. 2020

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Background The signs and symptoms of Zika virus infection are usually mild and self-limited. However, the disease has been linked to neurological complications such as Guillain-Barré syndrome and peripheral nerve involvement, and also to abortion and fetal deaths due to vertical transmission, resulting in various congenital malformations in newborns, including microcephaly. This review aimed to describe the o signs and symptoms that characterize the congenital Zika syndrome. Methods and findings A systematic review was performed with a protocol and described according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search strategy yielded 2,048 studies. After the exclusion of duplicates and application of inclusion criteria, 46 studies were included. The main signs and symptoms associated with the congenital Zika syndrome were microcephaly, parenchymal or cerebellar calcifications, ventriculomegaly, central nervous system hypoplasia or atrophy, arthrogryposis, ocular findings in the posterior and anterior segments, abnormal visual function and low birthweight for gestational age. Conclusions Zika virus infection during pregnancy can cause a series of changes in the growth and development of children, while impacting the healthcare system due to the severity of cases. Our findings outline the disease profile in newborns and infants and may contribute to the development and updating of more specific clinical protocols.

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“…The percentage of infants with a birth weight of < 2500 g in the group without microcephaly was 7 %, but the percentage increased to 48 % in the group with microcephaly, evidencing a strong association between low birth weight and microcephaly. A previous study conducted in the state of Bahia showed a 37.2 % prevalence of low birth weight in newborns with congenital ZIKV syndrome, including microcephaly [23]. In a study carried out in Guatemala, a birth weight of < −1 standard deviation and small for gestational age were associated with microcephaly [24].…”

Section: Variable Adjusted Odds Ratiomentioning

confidence: 83%

Zika Virus and Pregnancy: Association between Acute Infection and Microcephaly in Newborns in the State of Rio de Janeiro, Brazil

Pereira

Júnior

Werner

et al. 2020

Geburtshilfe Frauenheilkd

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Introduction Aim of the study was to evaluate the association between microcephaly and acute infection with Zika virus (ZIKV) in pregnant women in the state of Rio de Janeiro, Brazil. Infection was confirmed by laboratory testing. Materials and Methods A cross-sectional retrospective study of pregnant women with symptoms occurring between 2015 and 2016 suggestive of acute ZIKV infection was carried out, with confirmation of infection done by blood or urine RT-PCR. The relative proportions of categorical variables were calculated for two distinct groups: pregnant women whose newborns had microcephaly and pregnant women who gave birth to infants without microcephaly. Confidence intervals with a 95% level of agreement were estimated for the relative ratios. Results A total of 1609 pregnant women with a mean age of 26.4 ± 6.5 years were evaluated. As regards the time of acute infection, 19.6% (316) of cases occurred in the first trimester of pregnancy. Nineteen (76%) of the 25 cases with microcephaly (1.5%) were associated with an infection contracted in the first trimester of pregnancy (p < 0.001, OR = 13.7, 95% CI: 5.6 – 37.7). 48% (12/25) of the newborns with microcephaly had a birth weight of < 2500 grams, while only 7% (116/1597) of the group of newborns without microcephaly had a similarly low birth weight (p < 0.001, OR = 11.7, 95% CI: 5.2 – 26.2). Logistic regression showed that a birth weight of < 2500 g (OR = 12.54) and ZIKV infection in the first trimester of pregnancy (OR = 14.05) were associated with microcephaly (area under ROC curve = 0.86). Conclusion Acute ZIKV infection in the first trimester of pregnancy and low birth weight are associated with microcephaly.

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Congenital Zika Syndrome: Prevalence of low birth weight and associated factors. Bahia, 2015–2017

Cited by 24 publications

References 16 publications

Congenital Zika syndrome is associated with maternal protein malnutrition

Congenital Zika syndrome is associated with maternal protein malnutrition

Congenital Zika syndrome: A systematic review

Zika Virus and Pregnancy: Association between Acute Infection and Microcephaly in Newborns in the State of Rio de Janeiro, Brazil

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