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

• Autor(a) principal: Ximenes, Ricardo Arraes de Alencar
• Data de Publicação: 2023
• Outros Autores: Miranda Filho, Demócrito, Brickley, Elizabeth B, Araújo, Thalia Velho Barreto de, Montarroyos, Ulisses Ramos, Bernardino, Marília Rosa Abtibol, Pinhata, Marisa M. Mussi, Duarte, Geraldo, Coutinho, Conrado Milani, Negrini, Silvia Fabiana Biason de Moura, Alecrim, Maria das Graças Costa, Peixoto, Lucíola de Fátima Albuquerque de Almeida, Moreira, Maria Elisabeth Lopes, Zin, Andrea, Pereira Júnior, José Paulo, Saines, Karin Nielsen, Martelli, Celina Maria Turchi, Rodrigues, Laura Cunha, Souza, Wayner Vieira de, Ventura, Liana O, Oliveira, Consuelo Silva de, Matos, Haroldo de, Serra, Emilene Monteiro Furtado, Gomes, Luna Thais Souza, Nogueira, Maurício L, Estofolete, Cassia, Oliani, Denise Cristina Vaz, Passos, Saulo Duarte, Moron, Antonio, Rodrigues, Maria Manoela Duarte, Sarmento, Stéphanno Gomes Pereira, Turchi, Marília Dalva, Rosado, Luiza Emylce Pela, Zara, Ana Laura de Sene Amâncio, Gomes, Maria Bárbara Franco, Faccini, Lavínia Schuler, Silva, Juliana Herrero, Amorim, Melania M, Melo, Adriana Oliveira, Cunha, Antônio José Ledo Alves da, Barbosa, Arnaldo Prata, Amim Jr, Joffre, Rezende Filho, Jorge, Calcogno, Juan Ignacio, Alcantara, Luiz Carlos Júnior, Almeida, Breno Lima de, Hofer, Cristina Barroso, Machado, Elizabeth S, Siqueira, Isadora Cristina de, Espinosa, Flor Ernestina Martinez, Brasil, Patrícia
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Digital do Instituto Evandro Chagas (Patuá)
• Texto Completo: https://patua.iec.gov.br/handle/iec/6736
• topic: Zika virus / patogenicidade; Infecção por Zika virus / genética; Complicações na Gravidez; Gestantes; Metanálise em Rede; Estudos de Coortes

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%.