{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:32:28Z","timestamp":1787495548341,"version":"build-2736575974"},"reference-count":65,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>This retrospective cohort study analyzed 7870 pregnant women, including 2269 with confirmed Zika virus (ZIKV) infection and 5601 without Zika infection, along with their fetuses and newborns. Data were sourced from multiple databases in the state of Rio de Janeiro, Brazil. A propensity score model was employed to control confounding factors and stratify outcomes by pregnancy trimester. Among ZIKV+ pregnant women, 49 cases of congenital microcephaly or congenital nervous system (CNS) abnormalities were identified (2.16%, or 193.9 cases in 10,000 live births), whereas 44 cases were identified among ZIKV\u2212 women (0.78%, or 71.4 cases in 10,000 live births). Multivariable analysis yielded an odds ratio of 2.46 (95% CI 1.30\u20134.64) overall, with 4.29 (95% CI 1.93\u20139.53) in the first trimester, 5.29 (95% CI 1.08\u201325.95) in the second trimester, and 0.68 (95% CI 0.21\u20132.14) in the third trimester. The most frequent findings among ZIKV+ cases included intracranial calcifications, ventriculomegaly, posterior fossa malformations, reduced brain volume, corpus callosum malformations, cortex dysplasia, lissencephaly, and pachygyria. Ophthalmologic abnormalities were detected in 55.5% of cases, and brainstem auditory evoked potential anomalies were reported in 33.3%. ZIKV infection can result in structural or functional anomalies. Given the absence of specific treatment for congenital Zika syndrome (CZS), clinical care should prioritize monitoring and managing neurological, motor, auditory, visual, and orthopedic disorders in all children with in utero ZIKV exposure, especially during the first and second trimesters of pregnancy.<\/jats:p>","DOI":"10.3390\/v17020208","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T04:05:47Z","timestamp":1738296347000},"page":"208","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Neonatal Microcephaly and Central Nervous System Abnormalities During the Zika Outbreak in Rio de Janeiro"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5511-4764","authenticated-orcid":false,"given":"Marlos Melo","family":"Martins","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurology, Martag\u00e3o Gesteira Institute of Childcare and Pediatrics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto de Andrade","family":"Medronho","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-592, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4150-4403","authenticated-orcid":false,"given":"Carlos Eduardo","family":"Raymundo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-592, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4726-9782","authenticated-orcid":false,"given":"Arnaldo","family":"Prata-Barbosa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, D\u2019Or Institute for Research and Education (IDOR), Rio de Janeiro 2281-100, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Jos\u00e9 Ledo Alves","family":"da Cunha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21044-020, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1016\/S0140-6736(16)00651-6","article-title":"Association between Zika virus and microcephaly in French Polynesia, 2013\u20132015: A retrospective study","volume":"387","author":"Cauchemez","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/S0140-6736(17)31368-5","article-title":"Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: A surveillance-based analysis","volume":"390","author":"Carmo","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1136\/archdischild-2016-311541","article-title":"prevalence of microcephaly in eight south-eastern and midwestern Brazilian neonatal intensive care units: 2011\u20132015","volume":"102","author":"Robaina","year":"2017","journal-title":"Arch. 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