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. 2019 Mar 22;19(1):277.
doi: 10.1186/s12879-019-3908-4.

Factors associated with the development of Congenital Zika Syndrome: a case-control study

Giulia P Lima  1 , Daniel Rozenbaum  1 , Clarisse Pimentel  1 , Ana Cristina Cisne Frota  1 , Daniela Vivacqua  1 , Elizabeth S Machado  1 , Fernanda Sztajnbok  1 , Thalita Abreu  1 , Raquel A Soares  1 , Cristina B Hofer  2
Affiliations

Factors associated with the development of Congenital Zika Syndrome: a case-control study

Giulia P Lima et al. BMC Infect Dis. .

Abstract

Background: We aim to investigate possible maternal- and pregnancy-related factors associated with the development of Congenital Zika Syndrome (CZS) in children of mothers with probable gestational infection.

Methods: This case-control study, we recruited mother-infant pairs between May 2015 and October 2017 in a pediatric infectious disease clinic in Rio de Janeiro. Inclusion criteria required either that the mother reported Zika infection symptoms during pregnancy or that the infant presented with clinical or imaging features of the CZS. Exclusion criteria included detection of an alternative cause for the patient's presentation or negative polymerase chain reaction assays for Zika in all specimens tested within 12 days from the beginning of maternal symptoms. Infants with CZS (CDC definition) were selected as cases and infants without CZS, but with probable maternal Zika virus infection during pregnancy, were selected as controls. Maternal and pregnancy-related informations were collected and their relationship to the presence of congenital anomalies due to CZS was assessed by Fisher exact or Mann-Whitney test.

Results: Out of the 42 included neonates, 24 (57.1%) were diagnosed with CZS (cases). The mean maternal age at the birth was 21 years old. The early occurrence of maternal symptoms during pregnancy was the only variable associated with CZS (odds ratio = 0.87, 95% CI: 0.78-0.97). Case's mothers presented symptoms until the 25th week of gestational age (GA), while control's mothers presented until 36th weeks of GA. Income; illicit drug, alcohol, or tobacco use during pregnancy; other infections during pregnancy (including previous dengue infection) were not associated with CZS.

Conclusions: Our study corroborates the hypothesis that Zika virus infection earlier in pregnancy is a risk factor to the occurrence of congenital anomalies in their fetuses.

Keywords: Case-control; Congenital Zika Syndrome; Gestational age; Rio de Janeiro.

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Conflict of interest statement

Ethics approval and consent to participate

This project and its informed consent were approved by the Ethics Committee of the IPPMG, Written informed consent was obtained from all participants guardians.

Consent for publication

N/A

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Maternal Gestational Age at Zika infection. Legend: Cases were defined as royal blue lines, and controls as orange lines
See this image and copyright information in PMC

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References

    1. WHO. Zika Situation report. 31 March 2016. On: http://www.who.int/emergencies/zika-virus/situation-report/31-march-2016... Accessed 2 Dec 2018.
    1. Pan American Health Organization. Zika cumulative cases [Internet]. 2017 [cited 2017 Oct 26] Available from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=1239... Accessed 5 Dec 2018.
    1. Costello A, Dua T, Duran P, Gülmezoglu M, Oladapo OT, Perea W, et al. Defining the syndrome associated with congenital Zika virus infection. Bull World Health Organ. 2016;94(6):406–406A. doi: 10.2471/BLT.16.176990. - DOI - PMC - PubMed
    1. Miranda-Filho DB, Martelli CM, Ximenes RA, Araújo TV, Rocha MA, Ramos RC, et al. Initial description of the presumed congenital Zika syndrome. Am J Public Health. 2016;106(4):598–600. doi: 10.2105/AJPH.2016.303115. - DOI - PMC - PubMed
    1. United Nations Development Programme. A Socio-economic Impact Assessment of the Zika Virus in Latin America and the Caribbean: with a focus on Brazil, Colombia and Suriname. 2017 Apr [cited 2017 Dec 04] Available from: http://www.undp.org/content/undp/en/home/librarypage/hiv-aids/a-socio-ec...