{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:50:30Z","timestamp":1789905030165,"version":"4.0.1"},"reference-count":29,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00c3\u00a9bec - Sant\u00c3\u00a9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2017,5,27]]},"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We assessed baseline prevalence, risk factors and outcomes of microcephaly in a large population of neonates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>All hospitals in the province of Quebec, Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>794 microcephalic and 1 944 010 non-microcephalic infants born between 1989 and 2012.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Baseline prevalence of microcephaly and occurrence of other congenital anomalies. We estimated the association of (1) pregnancy risk factors including TORCH infections (toxoplasmosis, rubella, cytomegalovirus, herpes, other), exposure to teratogens, diabetes and maternal congenital anomalies with risk of microcephaly, and (2) microcephaly with risk of infant mortality and severe morbidity, adjusted for maternal characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall prevalence of microcephaly was 4.1 per 10 000, ranging between 3.0 and 5.3 per 10\u2009000 over time. Only 37% of microcephalic infants presented with other congenital anomalies. Maternal infection during pregnancy was the strongest risk factor, with 32 times the risk of microcephaly (prevalence ratio 32.38; 95% CI 22.42 to 46.75) compared with no infection. Exposure to teratogens was the next most important risk factor, with three times greater risk (prevalence ratio 3.10; 95% CI 2.37 to 4.07). Microcephaly was associated with 20 times the risk of infant mortality compared with no microcephaly (prevalence ratio 20.52; 95% CI 15.57 to 27.04) and significantly greater infant morbidity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In Canada, infectious exposure during pregnancy is a strong risk factor for microcephaly, and affected infants are at higher risk of poor birth outcomes. Better monitoring of microcephaly is needed in the event that Zika or other novel viruses affect future risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2016-311199","type":"journal-article","created":{"date-parts":[[2017,7,4]],"date-time":"2017-07-04T20:20:17Z","timestamp":1499199617000},"page":"F167-F172","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Congenital microcephaly in Quebec: baseline prevalence, risk factors and outcomes in a large cohort of neonates"],"prefix":"10.1136","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2412-0459","authenticated-orcid":false,"given":"Nathalie","family":"Auger","sequence":"first","affiliation":[{"name":"University of Montreal Hospital Research Centre, Montreal, Canada"},{"name":"Institut national de sant\u00e9 publique du Qu\u00e9bec, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Quach","sequence":"additional","affiliation":[{"name":"Institut national de sant\u00e9 publique du Qu\u00e9bec, Montreal, Canada"},{"name":"Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Healy-Profit\u00f3s","sequence":"additional","affiliation":[{"name":"University of Montreal Hospital Research Centre, Montreal, Canada"},{"name":"Institut national de sant\u00e9 publique du Qu\u00e9bec, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marie","family":"Lowe","sequence":"additional","affiliation":[{"name":"Institut national de sant\u00e9 publique du Qu\u00e9bec, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Arbour","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,4]]},"reference":[{"key":"2025090221342542000_103.2.F167.1","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2471\/BLT.16.171082","article-title":"Zika: the origin and spread of a mosquito-borne virus","volume":"94","author":"Kindhauser","year":"2016","journal-title":"Bull World Health Organ"},{"key":"2025090221342542000_103.2.F167.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)00073-6"},{"key":"2025090221342542000_103.2.F167.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600651"},{"key":"2025090221342542000_103.2.F167.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1602113"},{"key":"2025090221342542000_103.2.F167.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004543","article-title":"Differential susceptibilities of Aedes aegypti and Aedes albopictus from the Americas to Zika virus","volume":"10","author":"Chouin-Carneiro","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"2025090221342542000_103.2.F167.6","unstructured":"Government of Canada. 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