ArticleArchives of disease in childhood2020
Measurement error, microcephaly prevalence and implications for Zika: an analysis of Uruguay perinatal data.
Article in Archives of disease in childhood, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- A Fully-Integrated Bayesian Approach for the Imputation and Analysis of Derived Outcome Variables With Missingness.Statistics in medicine · 2026Article
- Adverse fetal and perinatal outcomes associated with Zika virus infection during pregnancy: an individual participant data meta-analysis.EClinicalMedicine · 2025Article
- Congenital anomalies during Covid-19: artifact of surveillance or a real TORCH?European journal of epidemiology · 2024Article
- Preparing for the next emerging perinatal infectious disease.Pediatric research · 2024Article
- Identifying possible inaccuracy in reported birth head circumference measurements among infants in the US Zika Pregnancy and Infant Registry.Birth defects research · 2022Article
- Pregnancy, Birth, Infant, and Early Childhood Neurodevelopmental Outcomes among a Cohort of Women with Symptoms of Zika Virus Disease during Pregnancy in Three Surveillance Sites, ProjectTropical medicine and infectious disease · 2021Article
- Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas.Tropical medicine and infectious disease · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
objectiveThe Zika virus outbreak has drawn attention to microcephaly, whose definition is based on head circumference measuring below a percentile or number of SDs below the mean. The objective of this analysis was to assess how differences in measurement precision might affect prevalence and trends of microcephaly.
methodsData from all births in Uruguay during 2010-2015 were obtained from the Perinatal Information System. The prevalence of births with microcephaly was calculated based on head circumference measurement at birth applying the INTERGROWTH-21
resultsRounding and digit preference was observed: 74% of head circumference measurements were reported as a whole centimetre value. The prevalence of births varied substantially by the criterion used to define microcephaly (<3 SD, <2 SD, <3rd percentile for gestational age) and could be halved or doubled based on adding or subtracting a half-centimetre from all reported head circumference measurements. If 4 days were added to gestational age calculations, rather than using completed gestational weeks (without days) for gestational age reporting, the prevalence was 1.7-2 times higher. DISCUSSION: Rounding in measurement of head circumference and reporting preferences of gestational age may have contributed to a lower prevalence of microcephaly than expected in this population. Differences in head circumference measurement protocols and gestational age dating have the potential to affect the prevalence of babies reported with microcephaly, and this limitation should be acknowledged when interpreting head circumference data collected for surveillance.
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