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Implications of Zika virus and congenital Zika syndrome for the number of live births in Brazil

Author

Listed:
  • Marcia C. Castro

    (Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA 02115)

  • Qiuyi C. Han

    (Statistics Department, Harvard University, Cambridge, MA 02138)

  • Lucas R. Carvalho

    (Center for Development and Regional Planning, Federal University of Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil)

  • Cesar G. Victora

    (Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, 96020-220, Rio Grande do Sul, Brazil)

  • Giovanny V. A. França

    (Secretariat of Health Surveillance, Brazilian Ministry of Health, Brasília, 70719-040, Distrito Federal, Brazil)

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.

Suggested Citation

  • Marcia C. Castro & Qiuyi C. Han & Lucas R. Carvalho & Cesar G. Victora & Giovanny V. A. França, 2018. "Implications of Zika virus and congenital Zika syndrome for the number of live births in Brazil," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 115(24), pages 6177-6182, June.
  • Handle: RePEc:nas:journl:v:115:y:2018:p:6177-6182
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    Citations

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    Cited by:

    1. Kelly, Ann H. & Lezaun, Javier & Löwy, Ilana & Matta, Gustavo Corrêa & de Oliveira Nogueira, Carolina & Rabello, Elaine Teixeira, 2020. "Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis," Social Science & Medicine, Elsevier, vol. 246(C).
    2. Marcos A. Rangel & Jenna Nobles & Amar Hamoudi, 2020. "Brazil’s Missing Infants: Zika Risk Changes Reproductive Behavior," Demography, Springer;Population Association of America (PAA), vol. 57(5), pages 1647-1680, October.
    3. Rangel, Marcos & Nobles, Jenna & Hamoudi, Amar, 2019. "Brazil's Missing Infants: Zika Risk Changes Reproductive Behavior," SocArXiv fu8bp, Center for Open Science.
    4. Letícia J. Marteleto & Gilvan Guedes & Raquel Z. Coutinho & Abigail Weitzman, 2020. "Live Births and Fertility Amid the Zika Epidemic in Brazil," Demography, Springer;Population Association of America (PAA), vol. 57(3), pages 843-872, June.
    5. Lívia Madeira Triaca & Felipe Garcia Ribeiro & César Augusto Oviedo Tejada, 2021. "Mosquitoes, birth rates and regional spillovers: Evidence from the Zika epidemic in Brazil," Papers in Regional Science, Wiley Blackwell, vol. 100(3), pages 795-813, June.
    6. Danielle A Freitas & Reinaldo Souza-Santos & Liege M A Carvalho & Wagner B Barros & Luiza M Neves & Patrícia Brasil & Mayumi D Wakimoto, 2020. "Congenital Zika syndrome: A systematic review," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-27, December.
    7. Jimena Barbeito-Andrés & Lavínia Schuler-Faccini & Patricia Pestana Garcez, 2018. "Why is congenital Zika syndrome asymmetrically distributed among human populations?," PLOS Biology, Public Library of Science, vol. 16(8), pages 1-11, August.
    8. Marwah Soliman & Vyacheslav Lyubchich & Yulia R. Gel, 2020. "Ensemble forecasting of the Zika space‐time spread with topological data analysis," Environmetrics, John Wiley & Sons, Ltd., vol. 31(7), November.
    9. Sudhan Rackimuthu & Reem Hunain & Zarmina Islam & Valentino Natoli & Ana Carla dos Santos Costa & Shoaib Ahmad & Mohammad Yasir Essar, 2022. "Zika virus amid COVID‐19 in India: A rising concern," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 556-560, January.

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