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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
Autor(es)
Ximenes, Ricardo Arraes de Alencar
Miranda-Filho, Demócrito de Barros
Brickley, Elizabeth B.
Araújo, Thalia Velho Barreto de
Montarroyos, Ulisses Ramos
Abtibol-Bernardino, Marília Rosa
Mussi-Pinhata, Marisa M.
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
Nielsen-Saines, Karin
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
Vaz-Oliani, Denise Cristina
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
Schuler-Faccini, Lavínia
Herrero-Silva, Juliana
Amorim, Melania M.
Melo, Adriana Oliveira
Cunha, Antônio José Ledo Alves da
Prata-Barbosa, Arnaldo
Amim Junior, Joffre
Rezende-Filho, Jorge
Calcagno, Juan Ignacio
Júnior Alcântara, Luiz Carlos
Almeida, Breno Lima de
Hofer, Cristina Barroso
Machado, Elizabeth S.
Siqueira, Isadora Cristina de
Martinez-Espinoza, Flor Ernestina
Brasil, Patrícia
Miranda-Filho, Demócrito de Barros
Brickley, Elizabeth B.
Araújo, Thalia Velho Barreto de
Montarroyos, Ulisses Ramos
Abtibol-Bernardino, Marília Rosa
Mussi-Pinhata, Marisa M.
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
Nielsen-Saines, Karin
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
Vaz-Oliani, Denise Cristina
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
Schuler-Faccini, Lavínia
Herrero-Silva, Juliana
Amorim, Melania M.
Melo, Adriana Oliveira
Cunha, Antônio José Ledo Alves da
Prata-Barbosa, Arnaldo
Amim Junior, Joffre
Rezende-Filho, Jorge
Calcagno, Juan Ignacio
Júnior Alcântara, Luiz Carlos
Almeida, Breno Lima de
Hofer, Cristina Barroso
Machado, Elizabeth S.
Siqueira, Isadora Cristina de
Martinez-Espinoza, Flor Ernestina
Brasil, Patrícia
Afiliação
Federal University of Pernambuco. Postgraduate Program in Tropical Medicine. Recife, PE, Brazil / University of Pernambuco. Post-Graduation in Health Sciences. Recife, PE, Brazil.
University of Pernambuco. Post-Graduation in Health Sciences. Recife, PE, Brazil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Federal University of Pernambuco. Postgraduate Program in Collective Health. Recife, PE, Brazil.
University of Pernambuco. Post-Graduation in Health Sciences. Recife, PE, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil.
Ribeirão Preto Medical School. Department of Pediatrics. Ribeirão Preto, SP, Brazil.
Ribeirão Preto Medical School. Department of Gynecology and Obstetrics. Ribeirão Preto, SP, Brazil.
Ribeirão Preto Medical School. Department of Gynecology and Obstetrics. Ribeirão Preto, SP, Brazil.
Ribeirão Preto Medical School. Department of Pediatrics. Ribeirão Preto, SP, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil.
Oswaldo Cruz Foundation. National Institute of Women's, Children's and Adolescents' Health Fernandes Figueira. Clinical Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Women's, Children's and Adolescents' Health Fernandes Figueira. Clinical Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Women's, Children's and Adolescents' Health Fernandes Figueira. Obstretics. Rio de Janeiro, RJ, Brazil.
David Geffen University of California at Los Angeles School of Medicine. Department of Pediatrics. LA, USA.
Oswaldo Cruz Foundation. Aggeu Magalhães Institute. Research Center Aggeu Magalhães. Recife, PE, Brazil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Oswaldo Cruz Foundation. Aggeu Magalhães Institute. Research Center Aggeu Magalhães. Recife, PE, Brazil.
Altino Ventura Foundation. Department of Ophthalmology. Recife, PE, Brazil / Pernambuco Eyes Hospital. Recife, PE, Brazil.
Evandro Chagas Institute. Department of Arbovirology and Hemorrhagic Fever. Ananindeua, PA, Brazil.
Evandro Chagas Institute. Department of Epidemiology. Ananindeua, PA, Brazil.
Evandro Chagas Institute. Department of Arbovirology and Hemorrhagic Fever. Ananindeua, PA, Brazil.
Evandro Chagas Institute. Department of Arbovirology and Hemorrhagic Fever. Ananindeua, PA, Brazil.
Medicine School of São José do Rio Preto. Department of Infectious Disease. São José do Rio Preto, SP, Brazil.
Medicine School of São José do Rio Preto. Department of Infectious Disease. São José do Rio Preto, SP, Brazil.
Medicine School of São José do Rio Preto. Department of Gynecology and Obstetrics. São José do Rio Preto, SP, Brazil.
Medicine School of Jundiaí. Infectious Pediatric Laboratory. Jundiaí, SP, Brazil.
Federal University of São Paulo. Department of Fetal Medicine. São Paulo, SP, Brazil.
Father Anchieta University Center. Nursing School. Jundiaí, SP, Brazil.
Federal University of São Paulo. Paulista School of Medicine. Departamentof Obstetrics. São Paulo, SP, Brazil.
Federal University of Goiás. Institute of Tropical Pathology and Public Health. Goiânia, GO, Brazil.
Health Secretariat of Goiás State. Maternal and Child Hospital. Goiânia, GO, Brazil.
Federal University of Goiás. Institute of Tropical Pathology and Public Health. Goiânia, GO, Brazil.
Health Secretariat of Goiás State. Maternal and Child Hospital. Goiânia, GO, Brazil.
Universidade Federal do Rio Grande do Sul. Hospital das Clínicas de Porto Alegre. Departamento de Genética. Porto Alegre, RS, Brasil.
Municipal Health Department. City Hall of Tangará da Serra. Tangará da Serra, MT, Brazil.
Federal University of Campina Grande. Medical Academic Unit. Campina Grande, PB, Brazil.
Federal University of Campina Grande. Medical Academic Unit. Campina Grande, PB, Brazil.
Federal University of Rio de Janeiro. Department of Pediatrics. Rio de Janeiro, RJ, Brazil.
D'Or Institute for Research & Education. Department of Pediatrics. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro Maternity School. Department of Obstectrics. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro Maternity School. Department of Obstectrics. Rio de Janeiro, RJ, Brazil.
Reference Maternity Prof. José Maria de Magalhães Netto. Bahia Health Department. Salvador, BA, Brazil.
Oswaldo Cruz Foundation. Gonçalo Moniz Institute. Salvador, BA, Brazil.
Oswaldo Cruz Foundation. Gonçalo Moniz Institute. Salvador, BA, Brazil.
Federal University of Rio de Janeiro. Department of Infecitous Diseases. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro. Department of Infecitous Diseases. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Gonçalo Moniz Institute. Salvador, BA, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Oswaldo Cruz Foundation. Leonidas and Maria Deane Institute. Manaus, AM, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil.
University of Pernambuco. Post-Graduation in Health Sciences. Recife, PE, Brazil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Federal University of Pernambuco. Postgraduate Program in Collective Health. Recife, PE, Brazil.
University of Pernambuco. Post-Graduation in Health Sciences. Recife, PE, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil.
Ribeirão Preto Medical School. Department of Pediatrics. Ribeirão Preto, SP, Brazil.
Ribeirão Preto Medical School. Department of Gynecology and Obstetrics. Ribeirão Preto, SP, Brazil.
Ribeirão Preto Medical School. Department of Gynecology and Obstetrics. Ribeirão Preto, SP, Brazil.
Ribeirão Preto Medical School. Department of Pediatrics. Ribeirão Preto, SP, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil.
Oswaldo Cruz Foundation. National Institute of Women's, Children's and Adolescents' Health Fernandes Figueira. Clinical Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Women's, Children's and Adolescents' Health Fernandes Figueira. Clinical Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Women's, Children's and Adolescents' Health Fernandes Figueira. Obstretics. Rio de Janeiro, RJ, Brazil.
David Geffen University of California at Los Angeles School of Medicine. Department of Pediatrics. LA, USA.
Oswaldo Cruz Foundation. Aggeu Magalhães Institute. Research Center Aggeu Magalhães. Recife, PE, Brazil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Oswaldo Cruz Foundation. Aggeu Magalhães Institute. Research Center Aggeu Magalhães. Recife, PE, Brazil.
Altino Ventura Foundation. Department of Ophthalmology. Recife, PE, Brazil / Pernambuco Eyes Hospital. Recife, PE, Brazil.
Evandro Chagas Institute. Department of Arbovirology and Hemorrhagic Fever. Ananindeua, PA, Brazil.
Evandro Chagas Institute. Department of Epidemiology. Ananindeua, PA, Brazil.
Evandro Chagas Institute. Department of Arbovirology and Hemorrhagic Fever. Ananindeua, PA, Brazil.
Evandro Chagas Institute. Department of Arbovirology and Hemorrhagic Fever. Ananindeua, PA, Brazil.
Medicine School of São José do Rio Preto. Department of Infectious Disease. São José do Rio Preto, SP, Brazil.
Medicine School of São José do Rio Preto. Department of Infectious Disease. São José do Rio Preto, SP, Brazil.
Medicine School of São José do Rio Preto. Department of Gynecology and Obstetrics. São José do Rio Preto, SP, Brazil.
Medicine School of Jundiaí. Infectious Pediatric Laboratory. Jundiaí, SP, Brazil.
Federal University of São Paulo. Department of Fetal Medicine. São Paulo, SP, Brazil.
Father Anchieta University Center. Nursing School. Jundiaí, SP, Brazil.
Federal University of São Paulo. Paulista School of Medicine. Departamentof Obstetrics. São Paulo, SP, Brazil.
Federal University of Goiás. Institute of Tropical Pathology and Public Health. Goiânia, GO, Brazil.
Health Secretariat of Goiás State. Maternal and Child Hospital. Goiânia, GO, Brazil.
Federal University of Goiás. Institute of Tropical Pathology and Public Health. Goiânia, GO, Brazil.
Health Secretariat of Goiás State. Maternal and Child Hospital. Goiânia, GO, Brazil.
Universidade Federal do Rio Grande do Sul. Hospital das Clínicas de Porto Alegre. Departamento de Genética. Porto Alegre, RS, Brasil.
Municipal Health Department. City Hall of Tangará da Serra. Tangará da Serra, MT, Brazil.
Federal University of Campina Grande. Medical Academic Unit. Campina Grande, PB, Brazil.
Federal University of Campina Grande. Medical Academic Unit. Campina Grande, PB, Brazil.
Federal University of Rio de Janeiro. Department of Pediatrics. Rio de Janeiro, RJ, Brazil.
D'Or Institute for Research & Education. Department of Pediatrics. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro Maternity School. Department of Obstectrics. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro Maternity School. Department of Obstectrics. Rio de Janeiro, RJ, Brazil.
Reference Maternity Prof. José Maria de Magalhães Netto. Bahia Health Department. Salvador, BA, Brazil.
Oswaldo Cruz Foundation. Gonçalo Moniz Institute. Salvador, BA, Brazil.
Oswaldo Cruz Foundation. Gonçalo Moniz Institute. Salvador, BA, Brazil.
Federal University of Rio de Janeiro. Department of Infecitous Diseases. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro. Department of Infecitous Diseases. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Gonçalo Moniz Institute. Salvador, BA, Brazil.
University of Amazonas State. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Doctor Heitor Vieira Dourado Tropical Medicine Foundation. Postgraduate Program in Tropical Medicine. Manaus, AM, Brazil / Oswaldo Cruz Foundation. Leonidas and Maria Deane Institute. Manaus, AM, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil.
Resumo em Inglês
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%.
Editor
Elsevier
Referência
XIMENES, Ricardo Arraes de Alencar et al. 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. Lancet Regional Health. Americas, v. 17, p. 1-12, Jan. 2023.DOI
10.1016/j.lana.2022.100395ISSN
2667-193XItens relacionados
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