{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:27:00Z","timestamp":1790303220740,"version":"4.1.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"French Ministry of Health","award":["Soutien Exceptionnel \u00e0 la Recherche et \u00e0 l\u2019Innovation"],"award-info":[{"award-number":["Soutien Exceptionnel \u00e0 la Recherche et \u00e0 l\u2019Innovation"]}]},{"name":"Laboratoire d'EXcellence Integrative Biology of Emerging Infectious Diseases Project","award":["ANR-10-LABEX-62-IBEID"],"award-info":[{"award-number":["ANR-10-LABEX-62-IBEID"]}]},{"name":"Horizon 2020 Research and Innovation Program","award":["73458"],"award-info":[{"award-number":["73458"]}]},{"DOI":"10.13039\/501100001677","name":"INSERM","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001677","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Institut Carnot Pasteur Maladie Infectieuse","award":["ANR 11-CARN 017-01"],"award-info":[{"award-number":["ANR 11-CARN 017-01"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In the French Territories in the Americas (FTA), the risk of birth defects possibly associated with Zika virus (ZIKV) infection was 7.0% (95%CI: 5.0 to 9.5) among foetuses\/infants of 546 women with symptomatic RT-PCR confirmed ZIKV infection during pregnancy. Many of these defects were isolated measurement-based microcephaly (i.e. without any detected brain or clinical abnormalities) or mild neurological conditions. We wanted to estimate the proportion of such minor findings among live births of women who were pregnant in the same region during the outbreak period but who were not infected with ZIKV.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In Guadeloupe, pregnant women were recruited at the time of delivery and tested for ZIKV infection. The outcomes of live born infants of ZIKV non-infected women were compared to those of ZIKV-exposed live born infants in Guadeloupe, extracted from the FTA prospective cohort.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 490 live born infants without exposure to ZIKV, 42 infants (8.6%, 95%CI: 6.2\u201311.4) had mild abnormalities that have been described as \u2018potentially linked to ZIKV infection\u2019; all but one of these was isolated measurement-based microcephaly. Among the 241 live born infants with ZIKV exposure, the proportion of such abnormalities, using the same definition, was similar (6.6%, 95%CI: 3.8\u201310.6).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Isolated anthropometric abnormalities and mild neurological conditions were as prevalent among infants with and without in-utero ZIKV exposure. If such abnormalities had not been considered as \u2018potentially linked to ZIKV\u2019 in the original prospective cohort in Guadeloupe, the overall estimate of the risk of birth defects considered due to the virus would have been significantly lower, at approximately 1.6% (95% CI: 0.4\u20134.1).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>ClinicalTrials.gov (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02916732\" xlink:type=\"simple\">NCT02916732<\/jats:ext-link>)<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0009048","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T19:11:52Z","timestamp":1614798712000},"page":"e0009048","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Reassessment of the risk of birth defects due to Zika virus in Guadeloupe, 2016"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2440-7553","authenticated-orcid":true,"given":"Anna L.","family":"Funk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-3017","authenticated-orcid":true,"given":"Bruno","family":"Hoen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Vingdassalom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0059-0752","authenticated-orcid":true,"given":"Catherine","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8759-6895","authenticated-orcid":true,"given":"Philippe","family":"Kadhel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinda","family":"Schepers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2248-8989","authenticated-orcid":true,"given":"Stanie","family":"Gaete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9585-4281","authenticated-orcid":true,"given":"Benoit","family":"Tressi\u00e8res","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Fontanet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"issue":"6","key":"pntd.0009048.ref001","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/S1473-3099(16)00095-5","article-title":"Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study","volume":"16","author":"G Calvet","year":"2016","journal-title":"Lancet Infect Dis"},{"issue":"10030","key":"pntd.0009048.ref002","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/S0140-6736(16)30253-7","article-title":"Positive IgM for Zika virus in the cerebrospinal fluid of 30 neonates with microcephaly in Brazil","volume":"387","author":"MT Cordeiro","year":"2016","journal-title":"Lancet"},{"issue":"3","key":"pntd.0009048.ref003","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/S1473-3099(17)30727-2","article-title":"Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study","volume":"18","author":"TVB de Araujo","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"pntd.0009048.ref004","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S2352-4642(18)30020-8","article-title":"Association and birth prevalence of microcephaly attributable to Zika virus infection among infants in Para\u00edba, Brazil, in 2015\u201316: a case-control study","volume":"2","author":"ER Krow-Lucal","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"issue":"1","key":"pntd.0009048.ref005","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1186\/s13104-017-2796-1","article-title":"Association between suspected Zika virus disease during pregnancy and giving birth to a newborn with congenital microcephaly: a matched case-control study.","volume":"10","author":"TH Santa Rita","year":"2017","journal-title":"BMC Res Notes"},{"issue":"3","key":"pntd.0009048.ref006","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1001\/jamapediatrics.2016.3982","article-title":"Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians","volume":"171","author":"CA Moore","year":"2017","journal-title":"JAMA Pediatr"},{"key":"pntd.0009048.ref007","article-title":"Ocular abnormalities in congenital Zika syndrome: are the ophthalmoscopic findings \"the top of the iceberg\"?","author":"JRO Dias","year":"2018","journal-title":"Prog Retin Eye Res"},{"issue":"6","key":"pntd.0009048.ref008","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.4269\/ajtmh.17-1020","article-title":"Seizures as a Complication of Congenital Zika Syndrome in Early Infancy","volume":"98","author":"J Oliveira-Filho","year":"2018","journal-title":"Am J Trop Med Hyg"},{"issue":"Suppl 2","key":"pntd.0009048.ref009","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1542\/peds.2017-2038D","article-title":"Development of Infants With Congenital Zika Syndrome: What Do We Know and What Can We Expect?","volume":"141","author":"AC Wheeler","year":"2018","journal-title":"Pediatrics"},{"issue":"24","key":"pntd.0009048.ref010","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1056\/NEJMoa1602412","article-title":"Zika Virus Infection in Pregnant Women in Rio de Janeiro","volume":"375","author":"P Brasil","year":"2016","journal-title":"N Engl J Med"},{"issue":"23","key":"pntd.0009048.ref011","doi-asserted-by":"crossref","first-page":"615","DOI":"10.15585\/mmwr.mm6623e1","article-title":"Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy\u2014U.S. Territories, January 1, 2016-April 25, 2017.","volume":"66","author":"CK Shapiro-Mendoza","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"11","key":"pntd.0009048.ref012","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1056\/NEJMoa1709481","article-title":"Pregnancy Outcomes after ZIKV Infection in French Territories in the Americas","volume":"378","author":"B Hoen","year":"2018","journal-title":"N Engl J Med"},{"key":"pntd.0009048.ref013","doi-asserted-by":"crossref","first-page":"k4431","DOI":"10.1136\/bmj.k4431","article-title":"Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana","volume":"363","author":"L Pomar","year":"2018","journal-title":"BMJ"},{"issue":"6","key":"pntd.0009048.ref014","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1002\/uog.17404","article-title":"Association between Zika virus and fetopathy: a prospective cohort study in French Guiana.","volume":"49","author":"L Pomar","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"pntd.0009048.ref015","doi-asserted-by":"crossref","first-page":"292.e1","DOI":"10.1016\/j.ajog.2017.01.018","article-title":"Infant outcomes among women with Zika virus infection during pregnancy: results of a large prenatal Zika screening program.","volume":"216","author":"EH Adhikari","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"10","key":"pntd.0009048.ref016","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/S2213-8587(14)70121-4","article-title":"The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st Project: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study","volume":"2","author":"J Villar","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"31","key":"pntd.0009048.ref017","first-page":"858","article-title":"Vital Signs: Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection\u2014U.S. Territories and Freely Associated States, 2018.","volume":"67","author":"ME Rice","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"3","key":"pntd.0009048.ref018","doi-asserted-by":"crossref","first-page":"91","DOI":"10.15585\/mmwr.mm6703a2","article-title":"Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection\u201415 States and U.S. Territories, 2016.","volume":"67","author":"A Delaney","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"pntd.0009048.ref019","doi-asserted-by":"crossref","first-page":"j5018","DOI":"10.1136\/bmj.j5018","article-title":"Prevalence and clinical profile of microcephaly in South America pre-Zika, 2005\u201314: prevalence and case-control study","volume":"359","author":"IM Orioli","year":"2017","journal-title":"BMJ"},{"key":"pntd.0009048.ref020","doi-asserted-by":"crossref","first-page":"i4721","DOI":"10.1136\/bmj.i4721","article-title":"Prevalence of microcephaly in Europe: population based study","volume":"354","author":"JK Morris","year":"2016","journal-title":"BMJ"},{"issue":"1","key":"pntd.0009048.ref021","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.diagmicrobio.2017.09.001","article-title":"Kinetics of anti-ZIKV antibodies after Zika infection using two commercial enzyme-linked immunoassays","volume":"90","author":"C Pasquier","year":"2018","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"8","key":"pntd.0009048.ref022","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1093\/cid\/cix967","article-title":"Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection","volume":"66","author":"L Barzon","year":"2018","journal-title":"Clin Infect Dis"},{"issue":"6","key":"pntd.0009048.ref023","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.3201\/eid2506.180361","article-title":"Performance of 2 Commercial Serologic Tests for Diagnosing Zika Virus Infection","volume":"25","author":"S Matheus","year":"2019","journal-title":"Emerg Infect Dis"},{"issue":"11","key":"pntd.0009048.ref024","doi-asserted-by":"crossref","first-page":"e01151","DOI":"10.1128\/JCM.01151-19","article-title":"Kinetics of anti-Zika virus antibodies after acute infection in pregnant women","volume":"57","author":"B Hoen","year":"2019","journal-title":"J Clin Microbiol"},{"key":"pntd.0009048.ref025","unstructured":"Euroimmun. Euroimmun test systems for the diagnosis of Zika virus infections. Available online at: https:\/\/www.euroimmun.com\/documents\/Indications\/Infections\/Zika-virus\/HI_2668_I_UK_B.pdf"},{"issue":"6","key":"pntd.0009048.ref026","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1002\/pd.2510","article-title":"Termination of pregnancy following prenatal diagnosis in France: how severe are the foetal anomalies?","volume":"30","author":"ICI Group Club de m\u00e9decine foetale","year":"2010","journal-title":"Prenat Diagn"},{"issue":"6","key":"pntd.0009048.ref027","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/j.1471-0528.2010.02531.x","article-title":"EUROCAT Working Group. Termination of pregnancy for fetal anomaly after 23 weeks of gestation: a European register-based study.","volume":"117","author":"E Garne","year":"2010","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology."},{"key":"pntd.0009048.ref028","unstructured":"Pan American Health Organization \/ World Health Organization. French Guiana, Guadeloupe, and Martinique. Health in the Americas 2007: Volume II\u2013Countries: 344\u2013360. Available online at: https:\/\/www.paho.org\/hq\/dmdocuments\/2010\/Health_in_the_Americas_2007-French_Guiana_Guadeloupe_and_Martinique.pdf"},{"issue":"7","key":"pntd.0009048.ref029","doi-asserted-by":"crossref","first-page":"e0219095","DOI":"10.1371\/journal.pone.0219095","article-title":"The French Pregnancy Cohort: Medication use during pregnancy in the French population.","volume":"14","author":"A B\u00e9rard","year":"2019","journal-title":"PloS One."},{"issue":"1","key":"pntd.0009048.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-58407-7","article-title":"Association of past dengue fever epidemics with the risk of Zika microcephaly at the population level in Brazil.","volume":"10","author":"MS Carvalho","year":"2020","journal-title":"Scientific reports."},{"issue":"8","key":"pntd.0009048.ref031","doi-asserted-by":"crossref","first-page":"e0201452","DOI":"10.1371\/journal.pone.0201452","article-title":"Zika might not be acting alone: Using an ecological study approach to investigate potential co-acting risk factors for an unusual pattern of microcephaly in Brazil.","volume":"13","author":"MC Campos","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"pntd.0009048.ref032","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s12889-018-5039-z","article-title":"Microcephaly epidemic related to the Zika virus and living conditions in Recife, Northeast Brazil.","volume":"18","author":"WV de Souza","year":"2018","journal-title":"BMC public health."},{"issue":"10","key":"pntd.0009048.ref033","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/S2213-8587(14)70186-X","article-title":"Fetal growth and ethnic variation","volume":"2","author":"PS Albert","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"3","key":"pntd.0009048.ref034","doi-asserted-by":"crossref","first-page":"e0172910","DOI":"10.1371\/journal.pone.0172910","article-title":"Evaluation of the INTERGROWTH-21st project newborn standard for use in Canada.","volume":"12","author":"S Liu","year":"2017","journal-title":"PLoS One"},{"issue":"Suppl 3","key":"pntd.0009048.ref035","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1111\/1471-0528.14008","article-title":"Impact of replacing Chinese ethnicity-specific fetal biometry charts with the INTERGROWTH-21st standard.","volume":"123","author":"YK Cheng","year":"2016","journal-title":"BJOG"},{"issue":"2","key":"pntd.0009048.ref036","doi-asserted-by":"crossref","first-page":"e20170589","DOI":"10.1542\/peds.2017-0589","article-title":"Prevalence and Risk Factors for Microcephaly at Birth in Brazil in 2010","volume":"141","author":"AA Silva","year":"2018","journal-title":"Pediatrics"},{"key":"pntd.0009048.ref037","article-title":"Vertical transmission of Zika virus and its outcomes: a Bayesian synthesis of prospective studies","author":"AE Ades","journal-title":"Lancet Infect Dis."},{"issue":"1","key":"pntd.0009048.ref038","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1128\/CMR.00062-12","article-title":"The \u201csilent\u201d global burden of congenital cytomegalovirus.","volume":"26","author":"S Manicklal","year":"2013","journal-title":"Clin Microbiol Rev"},{"issue":"4","key":"pntd.0009048.ref039","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.reprotox.2005.01.014","article-title":"Rubella infection in pregnancy.","volume":"21","author":"M De Santis","year":"2006","journal-title":"Reprod Toxicol"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T19:12:54Z","timestamp":1614798774000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009048"}},"subtitle":[],"editor":[{"given":"Claire","family":"Donald","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,3,3]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0009048","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,3]]}}}