ArticleProceedings of the National Academy of Sciences of the United States of America2018
Implications of Zika virus and congenital Zika syndrome for the number of live births in Brazil.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 107 citations in OpenAlex.
- Human fertility after a disaster: a systematic literature review.Proceedings. Biological sciences · 2023Pooled it
- Congenital Zika syndrome: A systematic review.PloS one · 2020Pooled it
- Exploring the Zika virus epidemic's association with fertility in a cohort of women of Northeastern Brazil: socioeconomic and educational gradients.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2025Article
- Income loss and fertility intentions during the COVID-19 pandemic in Brazil.Revista brasileira de estudos de populacao · 2025Article
- Fertility Intentions During the Covid-19 Pandemic: An Analysis of Individual- and Municipality-Level Determinants.Population and development review · 2024Article
- Single proxy control.Biometrics · 2024Article
- Microcephaly in South Brazil: Are cases of Congenital Zika Syndrome increasing in recent years?Genetics and molecular biology · 2024Article
- The relationship between staying at home during the pandemic and the number of conceptions: A national panel data analysis.PloS one · 2023Article
- Congenital Zika syndrome and living conditions in the largest city of northeastern Brazil.BMC public health · 2022Article
- Brazil's health system functionality amidst of the COVID-19 pandemic: An analysis of resilience.Lancet regional health. Americas · 2022Article
- Social determinants associated with Zika virus infection in pregnant women.PLoS neglected tropical diseases · 2021Article
- Congenital malformations in sub-Saharan Africa-warnings of a silent epidemic?The Lancet. Infectious diseases · 2021Article
- Inhibition of Zika virus replication by G-quadruplex-binding ligands.Molecular therapy. Nucleic acids · 2021Article
- Navigating women's reproductive health and childbearing during public health crises: Covid-19 and Zika in Brazil.World development · 2021Article
- Zika virus public health crisis and the perpetuation of gender inequality in Brazil.Reproductive health · 2021Article
- Abortion after the Zika virus epidemic in Northeast Brazil.Revista de saude publica · 2021Article
- Abortion in the times of Zika: the perspective of women in two Brazilian municipalities.Papeles de poblacion · 2021Article
- Scoping Review on the Impact of Outbreaks on Sexual and Reproductive Health Services: Proposed Frameworks for Pre-, Intra-, and Postoutbreak Situations.BioMed research international · 2021Article
- Microfluidic devices for the detection of viruses: aspects of emergency fabrication during the COVID-19 pandemic and other outbreaks.Proceedings. Mathematical, physical, and engineering sciences · 2020Review
- Brazil's Missing Infants: Zika Risk Changes Reproductive Behavior.Demography · 2020Article
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
An increase in microcephaly, associated with an epidemic of Zika virus (ZIKV) in Brazil, prompted the World Health Organization to declare a Public Health Emergency of International Concern in February 2016. While knowledge on biological and epidemiological aspects of ZIKV has advanced, demographic impacts remain poorly understood. This study uses time-series analysis to assess the impact of ZIKV on births. Data on births, fetal deaths, and hospitalizations due to abortion complications for Brazilian states, from 2010 to 2016, were used. Forecasts for September 2015 to December 2016 showed that 119,095 fewer births than expected were observed, particularly after April 2016 (a reduction significant at 0.05), demonstrating a link between publicity associated with the ZIKV epidemic and the decline in births. No significant changes were observed in fetal death rates. Although no significant increases in hospitalizations were forecasted, after the ZIKV outbreak hospitalizations happened earlier in the gestational period in most states. We argue that postponement of pregnancy and an increase in abortions may have contributed to the decline in births. Also, it is likely that an increase in safe abortions happened, albeit selective by socioeconomic status. Thus, the ZIKV epidemic resulted in a generation of congenital Zika syndrome (CZS) babies that reflect and exacerbate regional and social inequalities. Since ZIKV transmission has declined, it is unlikely that reductions in births will continue. However, the possibility of a new epidemic is real. There is a need to address gaps in reproductive health and rights, and to understand CZS risk to better inform conception decisions.
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