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Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis

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  • Marlos Melo Martins
  • Antonio José Ledo Alves da Cunha
  • Jaqueline Rodrigues Robaina
  • Carlos Eduardo Raymundo
  • Arnaldo Prata Barbosa
  • Roberto de Andrade Medronho

Abstract

The occurrence of fetal and neonatal disorders in pregnant women with Zika virus infection in the literature is not consistent. This study aims to estimate the prevalence rate of these disorders in fetuses/neonates of pregnant women with confirmed or probable infection by Zika virus. A systematic review with meta-analysis was conducted in November 2020. Cohort studies that contained primary data on the prevalence of unfavorable outcomes in fetuses or neonates of women with confirmed or probable Zika virus infection during pregnancy were included. A total of 21 cohort studies were included, with a total of 35,568 pregnant women. The meta-analysis showed that central nervous system abnormalities had the highest prevalence ratio of 0.06 (95% CI 0.03–0.09). Intracranial calcifications had a prevalence ratio of 0.01 (95% CI 0.01–0.02), and ventriculomegaly 0.01 (95% CI 0.01–0.02). The prevalence ratio of microcephaly was 0.03 (95% CI 0.02–0.05), fetal loss (miscarriage and stillbirth) was 0.04 (95% CI 0.02–0.06), Small for Gestational Age was 0.04 (95% CI 0.00–0,09), Low Birth Weight was 0.05 (95% CI 0.03–0.08) and Prematurity was 0.07 (95% CI 0.04–0.10). The positivity in RT-PCR for ZIKV performed in neonates born to infected mothers during pregnancy was 0.25 (95% CI 0.06–0.44). We also performed the meta-analysis of meta-analysis for microcephaly with the prevalence ratios from other two previously systematic reviews: 0.03 (95% CI 0.00–0.25). Our results contribute to measuring the impact of Zika virus infection during pregnancy on children’s health. The continuous knowledge of this magnitude is essential for the implementation development of health initiatives and programs, in addition to promoting disease prevention, especially in the development of a vaccine for Zika virus. PROSPERO protocol registration: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019125543.

Suggested Citation

  • Marlos Melo Martins & Antonio José Ledo Alves da Cunha & Jaqueline Rodrigues Robaina & Carlos Eduardo Raymundo & Arnaldo Prata Barbosa & Roberto de Andrade Medronho, 2021. "Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-26, February.
    • Handle: RePEc:plo:pone00:0246643
    DOI: 10.1371/journal.pone.0246643
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    Cited by:

    1. Myriam Patricia Cifuentes & Clara Mercedes Suarez & Ricardo Cifuentes & Noel Malod-Dognin & Sam Windels & Jose Fernando Valderrama & Paul D. Juarez & R. Burciaga Valdez & Cynthia Colen & Charles Phill, 2022. "Big Data to Knowledge Analytics Reveals the Zika Virus Epidemic as Only One of Multiple Factors Contributing to a Year-Over-Year 28-Fold Increase in Microcephaly Incidence," IJERPH, MDPI, vol. 19(15), pages 1-21, July.

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