Mortality from congenital zika syndrome: nationwide cohort study in Brazil

dc.creatorPaixão, Enny S.
dc.creatorCardim, Luciana L.
dc.creatorCosta, Maria C. N.
dc.creatorBrickley, Elizabeth B.
dc.creatorCarvalho-Sauer, Rita C. O. de
dc.creatorCarmo, Eduardo H.
dc.creatorAndrade, Roberto F. S.
dc.creatorRodrigues, Moreno S.
dc.creatorVeiga, Rafael V.
dc.creatorCosta, Larissa C.
dc.creatorMoore, Cynthia A.
dc.creatorFrança, Giovanny V. A.
dc.creatorSmeeth, Liam
dc.creatorRodrigues, Laura C.
dc.creatorBarreto, Mauricio L.
dc.creatorTeixeira, Maria G.
dc.date2022-03-03T14:30:53Z
dc.date2022-03-03T14:30:53Z
dc.date2022
dc.date.accessioned2023-09-26T21:10:05Z
dc.date.available2023-09-26T21:10:05Z
dc.identifierPAIXÃO, Enny S. et al. Mortality from congenital zika syndrome: nationwide cohort study in Brazil. The New England Journal of Medicine, v. 386, n.8, p.757-767, 2022.
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/51518
dc.identifier10.1056/NEJMoa2101195
dc.identifier1533-4406
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8870222
dc.descriptionSupported by the Secretary of Health Surveillance, Ministry of Health of Brazil, and by grants from the Wellcome Trust (213589/Z/18/Z, to Dr. Paixao), the Wellcome Trust with the U.K. Department for International Development (205377/Z/16/Z, to Dr. Barreto), the British Council Newton Fund (527418645, to Dr. Brickley), and the European Union Horizon 2020 Research and Innovation Program under the Zika Preparedness Latin American Network (ZikaPLAN; 734584, to Dr. Brickley).
dc.descriptionBACKGROUND Prenatal exposure to Zika virus has potential teratogenic effects, with a wide spec- trum of clinical presentation referred to as congenital Zika syndrome. Data on survival among children with congenital Zika syndrome are limited. METHODS In this population-based cohort study, we used linked, routinely collected data in Brazil, from January 2015 through December 2018, to estimate mortality among live-born children with congenital Zika syndrome as compared with those without the syndrome. Kaplan–Meier curves and survival models were assessed with ad- justment for confounding and with stratification according to gestational age, birth weight, and status of being small for gestational age. RESULTS A total of 11,481,215 live-born children were followed to 36 months of age. The mortality rate was 52.6 deaths (95% confidence interval [CI], 47.6 to 58.0) per 1000 person-years among live-born children with congenital Zika syndrome, as com- pared with 5.6 deaths (95% CI, 5.6 to 5.7) per 1000 person-years among those without the syndrome. The mortality rate ratio among live-born children with congenital Zika syndrome, as compared with those without the syndrome, was 11.3 (95% CI, 10.2 to 12.4). Among infants born before 32 weeks of gestation or with a birth weight of less than 1500 g, the risks of death were similar regardless of congenital Zika syndrome status. Among infants born at term, those with con- genital Zika syndrome were 14.3 times (95% CI, 12.4 to 16.4) as likely to die as those without the syndrome (mortality rate, 38.4 vs. 2.7 deaths per 1000 person- years). Among infants with a birth weight of 2500 g or greater, those with con- genital Zika syndrome were 12.9 times (95% CI, 10.9 to 15.3) as likely to die as those without the syndrome (mortality rate, 32.6 vs. 2.5 deaths per 1000 person- years). The burden of congenital anomalies, diseases of the nervous system, and infectious diseases as recorded causes of deaths was higher among live-born children with congenital Zika syndrome than among those without the syndrome. CONCLUSIONS The risk of death was higher among live-born children with congenital Zika syn- drome than among those without the syndrome and persisted throughout the first 3 years of life. (Funded by the Ministry of Health of Brazil and others.)
dc.formatapplication/pdf
dc.languageeng
dc.publisherMassachusetts Medical Society
dc.rightsopen access
dc.subjectMortality
dc.subjectCongenital Zika Syndrome
dc.subjectCohort Study
dc.subjectBrazil
dc.subjectMortality
dc.subjectCongenital Zika Syndrome
dc.subjectCohort Study
dc.subjectBrazil
dc.subjectMortalidade
dc.subjectInfecção por Zika virus
dc.subjectEstudos de Coortes
dc.subjectBrasil
dc.titleMortality from congenital zika syndrome: nationwide cohort study in Brazil
dc.typeArticle


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