SynthesisBMC public health2020
Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis.
Synthesis in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- A systematic review and meta-analysis of Zika virus epidemiology.Nature health · 2026Article
- Future disease burden due to the rise of emerging infectious disease secondary to climate change may be being under-estimated.Virulence · 2025Article
- Neonatal outcomes associated with maternal arbovirus infection (dengue, Zika, and chikungunya) among pregnant women with obstetric complications in Brazil: a cross-sectional study.Revista da Sociedade Brasileira de Medicina Tropical · 2025Article
- Characteristics, risk factors, and outcomes related to Zika virus infection during pregnancy in Northeastern Thailand: A prospective pregnancy cohort study, 2018-2020.PLoS neglected tropical diseases · 2024Article
- Perinatal characteristics and longer-term outcomes in Brazilian children with confirmed or suspected congenital Zika infection: ZIKAction Paediatric Registry.Dialogues in health · 2023Article
- Sociodemographic and Clinical Factors for Microcephaly Secondary to Teratogenic Infections in Brazil: An Ecological Study.Viruses · 2023Observational
- Zika Virus: A Systematic Review of Teratogenesis, Congenital Anomalies, and Child Mortality.Cureus · 2023Review
- Downregulation of transcriptional activity, increased inflammation, and damage in the placenta followingFrontiers in virology (Lausanne, Switzerland) · 2022Article
- Evidence of co-circulation of multiple arboviruses transmitted by Aedes species based on laboratory syndromic surveillance at a health unit in a slum of the Federal District, Brazil.Parasites & vectors · 2021Article
- The Ablation of Envelope Protein Glycosylation Enhances the Neurovirulence of ZIKV and Cell Apoptosis in Newborn Mice.Journal of immunology research · 2021Article
- Causes of Microcephaly in the Zika Era in Argentina: A Retrospective Study.Global pediatric health · 2021Article
- Hawai'i Journal Watch: Highlights of recent research from the University of Hawai'i and the Hawai'i State Department of Health.Hawai'i journal of health & social welfare · 2020Article
- Brain MRI in infants exposed to the Zika virus, with one-year follow-up: expanding the phenotype.Radiologia brasileiraArticle
Corrections and comments
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Authors and funding
14 authors at 8 institutions in 7 countries.
Funding
Abstract
backgroundAlthough it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the fetus, the prognostic factors associated with this tragic disorder remain unclear. We conducted a systematic review and meta-analysis to assess the prognostic factors associated with the incidence of microcephaly in congenital ZIKV infection.
methodsWe conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS, and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from the authors of the included studies to calculate summary estimates and conduct the meta-analysis of the most prevalent factors.
resultsWe screened 4106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6154 newborns/fetuses were enrolled; of those, 1120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in newborns/fetuses. Half of the studies provided primary data. Three out of 11 factors of interest seem to be prognostic factors of microcephaly: infant's sex - males compared to females: Relative Risk (RR) 1.30, 95% Confidence Interval (95% CI) 1.14 to 1.49; the stage of pregnancy when infection occurred - infection in the first trimester of pregnancy compared to infection at other stages of pregnancy: RR 1.41, 95% CI 1.09 to 1.82; and asymptomatic infection compared to symptomatic infection during pregnancy: RR 0.68; 95% CI 0.60 to 0.77.
conclusionOur findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when ZIKV infection occurs. Continued surveillance of ZIKV infection during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected fetuses. PROTOCOL REGISTRATION: This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration no. CRD 42018088075.
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