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.

Autor:	de Alencar Ximenes RA; Postgraduate Program in Tropical Medicine, Federal University of Pernambuco, Recife, PE, Brazil.; Post-Graduation in Health Sciences, University of Pernambuco, Recife, PE, Brazil., Miranda-Filho DB; Post-Graduation in Health Sciences, University of Pernambuco, Recife, PE, Brazil., Brickley EB; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., Barreto de Araújo TV; Postgraduate Program in Collective Health, Federal University of Pernambuco, Recife, PE, Brazil., Montarroyos UR; Post-Graduation in Health Sciences, University of Pernambuco, Recife, PE, Brazil., Abtibol-Bernardino MR; Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil.; Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil., Mussi-Pinhata MM; Department of Pediatrics, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil., Duarte G; Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil., Coutinho CM; Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil., Biason de Moura Negrini SF; Department of Pediatrics, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil., Costa Alecrim MDG; Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil.; Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil., Albuquerque de Almeida Peixoto LF; Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil.; Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil., Lopes Moreira ME; Clinical Research Unit, Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brazil., Zin A; Clinical Research Unit, Instituto Fernandes Figueira, Oswaldo Cruz Foundation, Fiocruz, Rio de Janeiro, RJ, Brazil., Pereira Júnior JP; Obstretics, Instituto Fernandes Figueira, Oswaldo Cruz Foundation, Fiocruz, Rio de Janeiro, Brazil., Nielsen-Saines K; Department of Pediatrics, David Geffen University of California at Los Angeles School of Medicine, LA, United States., Turchi Martelli CM; Research Center Aggeu Magalhães, Fiocruz, Recife, PE, Brazil., Rodrigues LC; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., de Souza WV; Research Center Aggeu Magalhães, Fiocruz, Recife, PE, Brazil., Ventura LO; Department of Ophthalmology, Altino Ventura Foundation, Recife, PE, Brazil.; Pernambuco Eyes Hospital, Recife, PE, Brazil., de Oliveira CS; Department of Arbovirology and Hemorrhagic Fever, Evandro Chagas Institute, Ananindeua, PA, Brazil., de Matos H; Department of Epidemiology, Evandro Chagas Institute, Ananindeua, PA, Brazil., Furtado Serra EM; Department of Arbovirology and Hemorrhagic Fever, Evandro Chagas Institute, Ananindeua, PA, Brazil., Souza Gomes LT; Department of Arbovirology and Hemorrhagic Fever, Evandro Chagas Institute, Ananindeua, PA, Brazil., Nogueira ML; Department of Infectious Disease, Medicine School of São José do Rio Preto, São José do Rio Preto, SP, Brazil., Estofolete C; Department of Infectious Disease, Medicine School of São José do Rio Preto, São José do Rio Preto, SP, Brazil., Vaz-Oliani DC; Department of Gynecology and Obstetrics, Medicine School of São José do Rio Preto, São José do Rio Preto, SP, Brazil., Passos SD; Infectious Pediatric Laboratory, Medicine School of Jundiaí, Jundiaí, SP, Brazil., Moron A; Department of Fetal Medicine, Federal University of São Paulo, São Paulo, SP, Brazil., Duarte Rodrigues MM; Nursing School, Father Anchieta University Center, Jundiaí, SP, Brazil., Pereira Sarmento SG; Departamentof Obstetrics, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil., Turchi MD; Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil., Pela Rosado LE; Maternal and Child Hospital, Health Secretariat of Goiás State, Goiânia, GO, Brazil., de Sene Amâncio Zara AL; Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil., Franco Gomes MB; Maternal and Child Hospital, Health Secretariat of Goiás State, Goiânia, GO, Brazil., Schuler-Faccini L; Departamento de Genética, Hospital das Clinicas de Porto Alegre, Universidade Federal do Rio Grandedo Sul, Porto Alegre, RS, Brazil., Herrero-Silva J; City Hall of Tangará da Serra, Municipal Health Department, Tangará da Serra, MT, Brazil., Amorim MM; Medical Academic Unit, Federal University of Campina Grande, Campina Grande, PB, Brazil., Melo AO; Medical Academic Unit, Federal University of Campina Grande, Campina Grande, PB, Brazil., Ledo Alves da Cunha AJ; Department of Pediatrics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Prata-Barbosa A; Department of Pediatrics, D'Or Institute for Research & Education, Rio de Janeiro, RJ, Brazil., Amim J Jr; Department of Obstectrics, Federal University of Rio de Janeiro Maternity School, Rio de Janeiro, RJ, Brazil., Rezende-Filho J; Department of Obstectrics, Federal University of Rio de Janeiro Maternity School, Rio de Janeiro, RJ, Brazil., Calcagno JI; Reference Maternity Prof. José Maria de Magalhães Netto, Bahia Health Department, Salvador, BA, Brazil., Júnior Alcântara LC; Gonçalo Moniz Institute, Fiocruz, Salvador, BA, Brazil., de Almeida BL; Gonçalo Moniz Institute, Fiocruz, Salvador, BA, Brazil., Hofer CB; Department of Infecitous Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Machado ES; Department of Infecitous Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., de Siqueira IC; Gonçalo Moniz Institute, Fiocruz, Salvador, BA, Brazil., Martinez-Espinoza FE; Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil.; Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil.; Leonidas and Maria Deane Institute, Fiocruz, Manaus, AM, Brazil., Brasil P; Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation, Fiocruz, Rio de Janeiro, Brazil.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2023 Jan; Vol. 17. Date of Electronic Publication: 2022 Nov 28.
DOI:	10.1016/j.lana.2022.100395
Abstrakt:	Background: 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. Methods: 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. Findings: 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. Interpretation: 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%. Competing Interests: Declaration of interests We declare no competing interests.
Databáze:	MEDLINE
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