{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:33:18Z","timestamp":1781825598225,"version":"3.54.5"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T00:00:00Z","timestamp":1602115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008353","name":"Funda\u00e7\u00e3o de Apoio ao Ensino, Pesquisa e Assist\u00eancia do Hospital das Cl\u00ednicas da Faculdade de Medicina de Ribeir\u00e3o Preto da Universidade de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008353","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To define the prevalence of adverse outcomes of maternal infection in a large cohort of ZIKV\u2010infected Brazilian women and their infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Ribeir\u00e3o Preto's region's private and public health facilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Symptomatic ZIKV\u2010infected mothers and their infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prenatal\/early neonatal data were obtained for all mother\u2013child pairs. A subgroup of infants had cranial ultrasonography, eye fundoscopy, hearing and neurological examinations and Bayley III screening tests within 3 months of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Prevalence of pregnancy losses and anomalies detected at birth or within 3\u00a0months according to the gestational age of infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 511 ZIKV\u2010infected women were identified from a total of 1116 symptomatic women; as there were two twins, there were a total of 513 fetuses included. Of these, 13 (2.5%; 95% CI 1.5\u20134.3) presented with major signs of congenital Zika syndrome (CZS). Of the 511 women, there were 489 livebirths and 24 (4.7%) pregnancy losses (20 miscarriages and four stillbirths). ZIKV\u2010related anomalies occurred in the offspring of 42\/511 (8.2%) mothers. Microcephaly or other CNS malformations were diagnosed in 1\/4 (25.0%) stillbirths and in 19\/489 (3.9%; 95% CI 2.5\u20135.9) of the liveborn infants. Fetal abnormalities were 14.0 (95% CI 7.6\u201326.0) times more likely with gestational infection occurring in \u226411\u00a0weeks. On follow up of 280 asymptomatic infants, 2\/155 (1.3%) had eye abnormalities, 1\/207 (0.5%) had CNS imaging findings and 16\/199 (8%) presented neurological alert signs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This prospective population\u2010based study represents the largest Brazilian cohort study of ZIKV in pregnancy. Congenital anomalies potentially associated with CZS are less frequent than previously thought. There is a strong association between the gestational age of infection (\u226411\u00a0weeks) and a poorer early infant prognosis. A notable proportion of apparently asymptomatic newborns can present with subclinical findings within 3\u00a0months of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>ZIKV and pregnancy: adverse outcomes are less common, more prevalent for first\u2010trimester infections, and potentially subclinical.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16490","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T20:55:32Z","timestamp":1601326532000},"page":"317-326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Early maternal Zika infection predicts severe neonatal neurological damage: results from the prospective Natural History of Zika Virus Infection in Gestation cohort 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