{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:47:22Z","timestamp":1785937642628,"version":"3.56.0"},"reference-count":31,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    The association between Zika virus (ZIKV) infection in pregnant women and congenital defects is well-established. However, the consequences of infection with both ZIKV and Chikungunya virus (CHIKV) during pregnancy remain poorly understood. The aim for the present study was to estimate and compare the risk of adverse outcomes in infants born to mothers infected with ZIKV alone and those born to mothers infected with both ZIKV and CHIKV during pregnancy. A cohort study was conducted, following pregnant women with rash who were reported to the Strategic Health Surveillance Information Center of the State of Pernambuco between 2015 and 2017 and underwent laboratory testing for ZIKV and CHIKV. All participants resided within a 120-kilometer radius of the city of Recife, Pernambuco, Brazil. Newborns were monitored through standardized assessments conducted by specialists from the Microcephaly Epidemic Research Group. Adverse outcomes were compared between newborns prenatally exposed to ZIKV alone and those exposed to both ZIKV and CHIKV using descriptive statistics, as well as RRs. A total of 278 children (\n                    <jats:italic>n<\/jats:italic>\n                    = 198 exposed to ZIKV alone;\n                    <jats:italic>n<\/jats:italic>\n                    = 80 exposed to ZIKV and CHIKV) were included. No significant differences were observed between the groups in the offspring\u2019s risks of microcephaly, low birth weight, prematurity, small for gestational age, dysphagia, neurological, ophthalmological, audiological, or neuroimaging abnormalities. Although previous studies have revealed that each infection independently may be associated with adverse outcomes in newborns, the present study generally revealed no difference in the frequency or type of adverse effects in children born to mothers infected with both ZIKV and CHIKV compared with those exposed only to ZIKV during pregnancy.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0512","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T15:34:19Z","timestamp":1781019259000},"page":"358-365","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Adverse Health Outcomes in Infants Born to Women Monoinfected with Zika Virus or Infected with Both Zika and Chikungunya Viruses during Pregnancy: A Prospective Cohort Study in Pernambuco, Brazil (2015\u20132017)"],"prefix":"10.4269","volume":"115","author":[{"given":"Gabriela Renata Neves","family":"Fulco","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Universidade de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Arraes de Alencar","family":"Ximenes","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas, Universidade de Pernambuco, Recife, Brazil;"},{"name":"Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulisses Ramos","family":"Montarroyos","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celina Maria Turchi","family":"Martelli","sequence":"additional","affiliation":[{"name":"Departamento de Sa\u00fade Coletiva, Instituto Aggeu Magalh\u00e3es, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thalia Velho Barreto de","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Social, Universidade Federal de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Brickley","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana de Carvalho Leal","family":"Gouveia","sequence":"additional","affiliation":[{"name":"Departamento de Cirurgia, Universidade Federal de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana Maria Viera de Oliveira","family":"Ventura","sequence":"additional","affiliation":[{"name":"Departamento de Oftalmologia, Funda\u00e7\u00e3o Altino Ventura, Recife, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Valqu\u00edria de Medeiros","family":"Silva","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Universidade de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Menezes Soares de Souza Aze","family":"Fontes","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Universidade de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dem\u00f3crito de Barros","family":"Miranda-Filho","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas, Universidade de Pernambuco, Recife, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"6","key":"b1","series-title":"Emerg Infect Dis","first-page":"1090","article-title":"Microcephaly in infants, Pernambuco State, Brazil, 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