Maternal Zika virus infection and newborn microcephaly-an analysis of the epidemiological evidence.

Abstract:

PURPOSE:To evaluate whether existing data and evidence support a causal link between maternal Zika virus (ZIKV) infection and newborn microcephaly. METHODS:I quantified and compared the prevalence of all and severe microcephaly in Brazil, during and before 2015-2016, to assess whether an outbreak has occurred, used time series analysis to evaluate if the presumed outbreak was linked to a previous outbreak of ZIKV infections, and quantitatively synthesized published data from observational studies testing this association. RESULTS:The prevalences of microcephaly in 2015-2016 were similar or lower than background levels (prevalence ratio [PR] for all microcephaly: 0.19; 95% confidence intervals [CI]: 0.17, 0.20). Changes in the number of cases of ZIKV infections at times matching 11-18 weeks of pregnancy were not followed by changes in the number of microcephaly cases (PR for infection at 12 weeks: 1.02; 95% CI: 0.99, 1.05). In observational studies, the prevalence of microcephaly was not significantly increased in newborns of Zika-infected mothers (average PR: 1.30; 95% CI: 0.84, 2.02). CONCLUSIONS:Existing evidence is insufficient to claim maternal ZIKV infection causes microcephaly. Although a public health response seems sensible, it should be consistent with existing knowledge and consider risks, potential benefits and harm, and competing priorities.

journal_name

Ann Epidemiol

journal_title

Annals of epidemiology

authors

Bautista LE

doi

10.1016/j.annepidem.2017.11.010

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

111-118

issue

2

eissn

1047-2797

issn

1873-2585

pii

S1047-2797(17)30283-1

journal_volume

28

pub_type

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