{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:48:11Z","timestamp":1790858891535,"version":"4.1.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5R01AI140718"],"award-info":[{"award-number":["5R01AI140718"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5R21AI129534"],"award-info":[{"award-number":["5R21AI129534"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["1R56AI172252"],"award-info":[{"award-number":["1R56AI172252"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","award":["1R21EY028318"],"award-info":[{"award-number":["1R21EY028318"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007175","name":"Brazilian National Council for Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007175","id-type":"DOI","asserted-by":"publisher"}]},{"name":"and Technological Development","award":["311562\/2021-3"],"award-info":[{"award-number":["311562\/2021-3"]}]},{"name":"and Technological Development","award":["311657\/2023-5"],"award-info":[{"award-number":["311657\/2023-5"]}]},{"name":"Carlos Chagas Filho Foundation for the Advancement of Science in the State of Rio de Janeiro","award":["E-26\/200.935\/2022"],"award-info":[{"award-number":["E-26\/200.935\/2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We investigated the association between maternal neutralizing antibodies (nAb) to Zika virus (ZIKV) in pregnancy and neonatal outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In pregnant participants with confirmed ZIKV infection, we determined trimester of infection, collected sera longitudinally, and measured nAbs via plaque reduction. In neonates, adverse outcomes included microcephaly (MC), structural brain abnormalities (SBA), hearing, and eye abnormalities. Associations between trimester of infection, nAbs, and neonatal outcomes were analyzed with Cox regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 137 ZIKV-positive pregnant participants had neutralization assays performed during pregnancy and postdelivery. Infection rates were 29% in the first, 50% in the second, and 21% in the third trimester. Mean ZIKV nAb titer &amp;gt;2 weeks postinfection was 64 258 (SD 213 288). Ten percent of 90% plaque reduction neutralization assays (PRNT90) titers were &amp;lt;500, 10% 500\u20131000, 73% &amp;gt; 1000, and 7% did not have serologic follow-up; 15%. of infants had adverse findings. Protective factors against MC in 88 mothers with nAb titers available during pregnancy included infection later in gestation (adjusted hazard ratio [aHR], 0.06; P = .036) and adequate nAb titers (aHR, 0.17; P = .014). No SBA was associated with later infection in pregnancy (aHR, 0.16; P = .017) and adequate nAb titers (aHR, 0.34; P = .012). Adjusting for trimester, higher maternal nAb titers were associated with lower risk of MC and SBA. Seven of 137 participants (5.1%) had positive serum ZIKV polymerase chain reaction (PCR) results beyond 14 days (range, 35\u2013269 days). Participants with ZIKV PCR positivity &amp;gt;60 days (n = 2) had infants with MC\/SBA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>MC and SBA were less frequent in infants of mothers with higher ZIKV nAb titers during pregnancy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf146","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T11:32:03Z","timestamp":1745235123000},"page":"639-648","source":"Crossref","is-referenced-by-count":5,"title":["Development of Maternal Antibodies Post ZIKV in Pregnancy is Associated with Lower Risk of Microcephaly and Structural Brain Abnormalities in Exposed Infants"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1742-5211","authenticated-orcid":false,"given":"Karin","family":"Nielsen-Saines","sequence":"first","affiliation":[{"name":"Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5818-221X","authenticated-orcid":false,"given":"Tahmineh","family":"Kalbasi-Romero","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Claudia Machado","family":"Duarte","sequence":"additional","affiliation":[{"name":"Institute of Technology on Immunobiologicals, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1840-2326","authenticated-orcid":false,"given":"Stephanie","family":"Almeida da Silva","sequence":"additional","affiliation":[{"name":"Institute of Technology on Immunobiologicals, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Adachi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Acute Febrile Illness Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2655-5605","authenticated-orcid":false,"given":"Tara","family":"Kerin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-4267","authenticated-orcid":false,"given":"Trevon","family":"Fuller","sequence":"additional","affiliation":[{"name":"Acute Febrile Illness Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]},{"name":"Institute of the Environment and Sustainability, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime G","family":"Deville","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Elisabeth","family":"Moreira","sequence":"additional","affiliation":[{"name":"Fernandes Figueira National Institute of Women\u2019s, Children\u2019s, and Adolescents\u2019 Health, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2193-2224","authenticated-orcid":false,"given":"Zilton","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Fernandes Figueira National Institute of Women\u2019s, Children\u2019s, and Adolescents\u2019 Health, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Zin","sequence":"additional","affiliation":[{"name":"Fernandes Figueira National Institute of Women\u2019s, Children\u2019s, and Adolescents\u2019 Health, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9706-1499","authenticated-orcid":false,"given":"Myung","family":"Shin-Sim","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila Maria","family":"Barbosa de Lima","sequence":"additional","affiliation":[{"name":"Institute of Technology on Immunobiologicals, Oswaldo Cruz Foundation , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-7976","authenticated-orcid":false,"given":"Patricia","family":"Brasil","sequence":"additional","affiliation":[{"name":"Acute Febrile Illness Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation , Rio de 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