Author | Paixão, Enny S. | |
Author | Cardim, Luciana L. | |
Author | Costa, Maria C. N. | |
Author | Brickley, Elizabeth B. | |
Author | Carvalho-Sauer, Rita C. O. de | |
Author | Carmo, Eduardo H. | |
Author | Andrade, Roberto F. S. | |
Author | Rodrigues, Moreno S. | |
Author | Veiga, Rafael V. | |
Author | Costa, Larissa C. | |
Author | Moore, Cynthia A. | |
Author | França, Giovanny V. A. | |
Author | Smeeth, Liam | |
Author | Rodrigues, Laura C. | |
Author | Barreto, Mauricio L. | |
Author | Teixeira, Maria G. | |
Access date | 2022-03-03T14:30:53Z | |
Available date | 2022-03-03T14:30:53Z | |
Document date | 2022 | |
Citation | PAIXÃO, Enny S. et al. Mortality from congenital zika syndrome: nationwide cohort study in Brazil. The New England Journal of Medicine, v. 386, n.8, p.757-767, 2022. | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/51518 | |
Description | Supported by the Secretary of Health Surveillance, Ministry of Health of Brazil, and by grants from the Wellcome Trust (213589/Z/18/Z, to Dr. Paixao), the Wellcome Trust with the U.K. Department for International Development (205377/Z/16/Z, to Dr. Barreto), the British Council Newton Fund (527418645, to Dr. Brickley), and the European Union Horizon 2020 Research and Innovation Program under the Zika Preparedness Latin American Network (ZikaPLAN; 734584, to Dr. Brickley). | pt_BR |
Language | eng | pt_BR |
Publisher | Massachusetts Medical Society | pt_BR |
Rights | open access | pt_BR |
MeSH | Mortality | pt_BR |
MeSH | Congenital Zika Syndrome | pt_BR |
MeSH | Cohort Study | pt_BR |
MeSH | Brazil | pt_BR |
Title | Mortality from congenital zika syndrome: nationwide cohort study in Brazil | pt_BR |
Type | Article | pt_BR |
DOI | 10.1056/NEJMoa2101195 | |
Abstract | BACKGROUND
Prenatal exposure to Zika virus has potential teratogenic effects, with a wide spec-
trum of clinical presentation referred to as congenital Zika syndrome. Data on
survival among children with congenital Zika syndrome are limited.
METHODS
In this population-based cohort study, we used linked, routinely collected data in
Brazil, from January 2015 through December 2018, to estimate mortality among
live-born children with congenital Zika syndrome as compared with those without
the syndrome. Kaplan–Meier curves and survival models were assessed with ad-
justment for confounding and with stratification according to gestational age,
birth weight, and status of being small for gestational age.
RESULTS
A total of 11,481,215 live-born children were followed to 36 months of age. The
mortality rate was 52.6 deaths (95% confidence interval [CI], 47.6 to 58.0) per 1000
person-years among live-born children with congenital Zika syndrome, as com-
pared with 5.6 deaths (95% CI, 5.6 to 5.7) per 1000 person-years among those
without the syndrome. The mortality rate ratio among live-born children with
congenital Zika syndrome, as compared with those without the syndrome, was
11.3 (95% CI, 10.2 to 12.4). Among infants born before 32 weeks of gestation or
with a birth weight of less than 1500 g, the risks of death were similar regardless
of congenital Zika syndrome status. Among infants born at term, those with con-
genital Zika syndrome were 14.3 times (95% CI, 12.4 to 16.4) as likely to die as
those without the syndrome (mortality rate, 38.4 vs. 2.7 deaths per 1000 person-
years). Among infants with a birth weight of 2500 g or greater, those with con-
genital Zika syndrome were 12.9 times (95% CI, 10.9 to 15.3) as likely to die as
those without the syndrome (mortality rate, 32.6 vs. 2.5 deaths per 1000 person-
years). The burden of congenital anomalies, diseases of the nervous system, and
infectious diseases as recorded causes of deaths was higher among live-born
children with congenital Zika syndrome than among those without the syndrome.
CONCLUSIONS
The risk of death was higher among live-born children with congenital Zika syn-
drome than among those without the syndrome and persisted throughout the first
3 years of life. (Funded by the Ministry of Health of Brazil and others.) | pt_BR |
Affilliation | London School of Hygiene and Tropical Medicine. London, UK / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | London School of Hygiene and Tropical Medicine. London, UK. | pt_BR |
Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | National Center on Birth Defects and Developmental Disabilities. Centers for Disease Control and Prevention. Division of Birth Defects and Infant Disorders. Atlanta, GA, USA. | pt_BR |
Affilliation | Ministério da Saúde. Secretaria de Vigilância em Saúde. Brasília, DF, Brasil. | pt_BR |
Affilliation | London School of Hygiene and Tropical Medicine. London, UK. | pt_BR |
Affilliation | London School of Hygiene and Tropical Medicine. London, UK. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | pt_BR |
Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil. | pt_BR |
Subject | Mortality | pt_BR |
Subject | Congenital Zika Syndrome | pt_BR |
Subject | Cohort Study | pt_BR |
Subject | Brazil | pt_BR |
DeCS | Mortalidade | pt_BR |
DeCS | Infecção por Zika virus | pt_BR |
DeCS | Estudos de Coortes | pt_BR |
DeCS | Brasil | pt_BR |
e-ISSN | 1533-4406 | |