ArticleThe Lancet. Infectious diseases2021
Vertical transmission of Zika virus and its outcomes: a Bayesian synthesis of prospective studies.
Article in The Lancet. Infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- COVID-19 Pandemic and Infant Neurodevelopmental Impairment: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Fetoplacental transmission and placental response to SARS-CoV-2: Evidence from the literature.Frontiers in medicine · 2022Pooled it
- Comprehensive analysis of epidemiological and clinical features of Oropouche virus infection (1975 to 2025): a systematic review.New microbes and new infections · 2026Review
- Comparative analysis of placental transmission mechanisms for Dengue and Zika viruses: outcomes and future directions.Frontiers in immunology · 2026Review
- Vertical Transmission of Zika Virus: The Immune-Pathophysiological Interface of the Placenta.Journal of immunology research · 2026Review
- [Expert consensus on the diagnosis, treatment, and prevention of neonatal dengue, chikungunya, and Zika virus infections (2025)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025Article
- Placenta - A Competent, But Not Infallible, Antiviral and Antiparasitic Barrier.Reproductive sciences (Thousand Oaks, Calif.) · 2025Review
- A decade later, what have we learned from the Zika epidemic in children with intrauterine exposure?Lancet (London, England) · 2025Review
- Article
- Review
- Multi-omics analysis reveals key immunogenic signatures induced by oncolytic Zika virus infection of paediatric brain tumour cells.Scientific reports · 2025Article
- Emerging Autochthonous Transmission of Travel-Associated Vector-Borne Infections in the Continental United States.Delaware journal of public health · 2025Article
- Infectivity in full-term placenta of Zika viruses with different lipid profiles.Virus research · 2025Article
- Comparison of Three Chimeric Zika Vaccine Prototypes Developed on the Genetic Background of the Clinically Proven Live-Attenuated Japanese Encephalitis Vaccine SAInternational journal of molecular sciences · 2024Article
- Neurodevelopment in the First 2 Years of Life Following Prenatal Exposure to Maternal SARS-CoV-2 Infection.JAMA network open · 2024Article
- Fetal Zika virus inoculation in macaques revealed control of the fetal viral load during pregnancy.Virology journal · 2024Article
- Arboviruses and pregnancy: are the threats visible or hidden?Tropical diseases, travel medicine and vaccines · 2024Article
- Zika virus infection during pregnancy and vertical transmission: case reports and peptide-specific cell-mediated immune responses.Archives of virology · 2024Article
- Perinatal characteristics and longer-term outcomes in Brazilian children with confirmed or suspected congenital Zika infection: ZIKAction Paediatric Registry.Dialogues in health · 2023Article
- Nanoluciferase Reporter Zika Viruses as Tools for Assessing Infection Kinetics and Antibody Potency.Viruses · 2023Article
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Authors and funding
7 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundProspective studies of Zika virus in pregnancy have reported rates of congenital Zika syndrome and other adverse outcomes by trimester. However, Zika virus can infect and damage the fetus early in utero, but clear before delivery. The true vertical transmission rate is therefore unknown. We aimed to provide the first estimates of underlying vertical transmission rates and adverse outcomes due to congenital infection with Zika virus by trimester of exposure.
methodsThis was a Bayesian latent class analysis of data from seven prospective studies of Zika virus in pregnancy. We estimated vertical transmission rates, rates of Zika-virus-related and non-Zika-virus-related adverse outcomes, and the diagnostic sensitivity of markers of congenital infection. We allowed for variation between studies in these parameters and used information from women in comparison groups with no PCR-confirmed infection, where available.
findingsThe estimated mean risk of vertical transmission was 47% (95% credible interval 26 to 76) following maternal infection in the first trimester, 28% (15 to 46) in the second, and 25% (13 to 47) in the third. 9% (4 to 17) of deliveries following infections in the first trimester had symptoms consistent with congenital Zika syndrome, 3% (1 to 7) in the second, and 1% (0 to 3) in the third. We estimated that in infections during the first, second, and third trimester, respectively, 13% (2 to 27), 3% (-5 to 14), and 0% (-7 to 11) of pregnancies had adverse outcomes attributable to Zika virus infection. Diagnostic sensitivity of markers of congenital infection was lowest in the first trimester (42% [18 to 72]), but increased to 85% (51 to 99) in trimester two, and 80% (42 to 99) in trimester three. There was substantial between-study variation in the risks of vertical transmission and congenital Zika syndrome.
interpretationThis preliminary analysis recovers the causal effects of Zika virus from disparate study designs. Higher transmission in the first trimester is unusual with congenital infections but accords with laboratory evidence of decreasing susceptibility of placental cells to infection during pregnancy.
fundingEuropean Union Horizon 2020 programme.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.