{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:49:35Z","timestamp":1789904975235,"version":"4.0.1"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>To estimate the baseline prevalence and risk factors for microcephaly at birth before the Zika virus epidemic in 2 Brazilian cities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We used population-based data from the Brazilian Ribeir\u00e3o Preto (RP) and S\u00e3o Lu\u00eds (SL) birth cohort studies of 2010 that included hospital deliveries by resident mothers. The final sample was 7376 live births in RP and 4220 in SL. Gestational age was based on the date of the mother\u2019s last normal menstrual period or obstetric ultrasonography, if available. Microcephaly at birth was classified according to the criteria of the International Fetal and Newborn Growth Consortium for the 21st Century and the Brazilian Ministry of Health. Risk factors for microcephaly, proportionate and disproportionate microcephaly, and severe microcephaly were estimated in a hierarchized logistic regression model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>According to the International Fetal and Newborn Growth Consortium for the 21st Century definition, the prevalence of microcephaly (&amp;gt;2 SDs below the mean for gestational age and sex) was higher in SL (3.5%) than in RP (2.5%). The prevalence of severe microcephaly (&amp;gt;3 SDs below the mean) was higher in SL (0.7%) than in RP (0.5%). Low maternal schooling, living in consensual union or without a companion, maternal smoking during pregnancy, primiparity, vaginal delivery, and intrauterine growth restriction were consistently associated with microcephaly. The number of cases of microcephaly is grossly underestimated, with an underreporting rate of \u223c90%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>The prevalence of severe microcephaly was much higher than expected in both cities. Our findings suggest that microcephaly was endemic in both municipalities before the circulation of the Zika virus.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2017-0589","type":"journal-article","created":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T08:30:22Z","timestamp":1515141022000},"source":"Crossref","is-referenced-by-count":35,"title":["Prevalence and Risk Factors for Microcephaly at Birth in Brazil in 2010"],"prefix":"10.1542","volume":"141","author":[{"given":"Ant\u00f4nio A.","family":"Silva","sequence":"first","affiliation":[{"name":"Departments of Public Health and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco A.","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Departments of Puericulture and Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria T.","family":"Alves","sequence":"additional","affiliation":[{"name":"Departments of Public Health and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina A.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Departments of Public Health and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ros\u00e2ngela F.","family":"Batista","sequence":"additional","affiliation":[{"name":"Departments of Public Health and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariz\u00e9lia R.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Medicine III, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Lamy-Filho","sequence":"additional","affiliation":[{"name":"Medicine III, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeni C.","family":"Lamy","sequence":"additional","affiliation":[{"name":"Departments of Public Health and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane C.","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Departments of Puericulture and Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo C.","family":"Cavalli","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanda M.","family":"Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Departments of Public Health and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heloisa","family":"Bettiol","sequence":"additional","affiliation":[{"name":"Departments of Puericulture and Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,2,1]]},"reference":[{"issue":"10","key":"2021121014413046900_B1","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.3201\/eid2110.150847","article-title":"Zika virus outbreak, Bahia, Brazil.","volume":"21","author":"Campos","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"2021121014413046900_B2","unstructured":"European Centre for Disease Prevention and Control\n          . Rapid risk assessment: microcephaly in Brazil potentially linked to the Zika virus epidemic. Available at: http:\/\/ecdc.europa.eu\/en\/publications\/Publications\/zika-microcephaly-Brazil-rapid-risk-assessment-Nov-2015.pdf. Accessed December 10, 2016"},{"issue":"4","key":"2021121014413046900_B3","doi-asserted-by":"crossref","first-page":"701","DOI":"10.5123\/S1679-49742016000400004","article-title":"Microcephaly in Brazil: prevalence and characterization of cases from the Information System on Live Births (SINASC), 2000-2015.","volume":"25","author":"Marinho","year":"2016","journal-title":"Epidemiol Serv Saude"},{"key":"2021121014413046900_B4","doi-asserted-by":"publisher","DOI":"10.2471\/blt.16.171223","article-title":"Establishing base levels of microcephaly in Brazil prior to the arrival of Zika viral illnesses [published online ahead of print February 8, 2016].","author":"Simmins","journal-title":"Bull World Health Organ"},{"key":"2021121014413046900_B5","unstructured":"Latin American Collaborative Study of Congenital Malformations\n          . ECLAM final document regarding the reported increase in microcephaly cases in Northeastern Brazil in 2015. 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Rapid Advice Guideline","author":"World Health Organization","year":"2016"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-0589\/918633\/peds_20170589.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-0589\/918633\/peds_20170589.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T04:18:34Z","timestamp":1639196314000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/141\/2\/e20170589\/38041\/Prevalence-and-Risk-Factors-for-Microcephaly-at"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,1]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,2,1]]},"published-print":{"date-parts":[[2018,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2017-0589","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,1]]},"article-number":"e20170589"}}