Por favor, use este identificador para citar o enlazar este ítem:
https://www.arca.fiocruz.br/handle/icict/43298
Tipo
ArtículoDerechos de autor
Acceso abierto
Colecciones
Metadatos
Mostrar el registro completo del ítem
ANOTHER PIECE OF THE ZIKA PUZZLE: ASSESSING THE ASSOCIATED FACTORS TO MICROCEPHALY IN A SYSTEMATIC REVIEW AND META-ANALYSIS
Microcephaly
Pregnancy
Congenital disease
Risk factors
Systematic review
Congenital Zika syndrome
Microcefalia
Transmissão Vertical de Doença Infecciosa
Revisão Sistemática
Autor
Afiliación
University of Brasilia. Postgraduate Program in Tropical Medicine. Brasilia, DF, Brazil / Queen’s University. Department of Obstetrics and Gynecology. Kingston, ON, Canada / University. Department of Public Health Sciences. Kingston, ON, Canada.
Queen’s University. Department of Medicine. Kingston, ON, Canada.
University of Brasilia. Postgraduate Program in Tropical Medicine. Brasilia, DF, Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
Queen’s University. Department of Obstetrics and Gynecology. Kingston, ON, Canada / University. Department of Public Health Sciences. Kingston, ON, Canada.
Queen’s University. Bracken Health Sciences Library. Kingston, ON, Canada.
University Hospital of Martinique. Maison de la Femme, de la Mère et de l’Enfant. Centre Pluridisciplinaire de Diagnostic Prénatal de le Martinique. Fort-de-France, Martinique, France.
Altino Ventura Foundation. Department of Scientific Investigation. Recife, PE, Brazil.
Brazilian Ministry of Health. Brasilia, DF, Brazil.
University Hospital. Département “Femme-Mère Enfant”. Materno-fetal and Obstetrics Research Unit. Lausanne, Switzerland / Centre Hospitalier de l’Ouest Guyanais Franck Joly. Department of Obstetrics and Gynaecology. Saint-Laurent-du-Maroni, French Guiana.
Altino Ventura Foundation. Department of Pediatric Ophthalmology and Strabismus. Recife, PE, Brazil.
University of Hawaii at Manoa. John A. Burns School of Medicine. Department of Tropical Medicine, Medical Microbiology and Pharmacology. Honolulu, HI, USA.
University of Brasilia. Postgraduate Program in Tropical Medicine. Brasilia, DF, Brazil.
Queen’s University. Department of Obstetrics and Gynecology. Kingston, ON, Canada / University. Department of Public Health Sciences. Kingston, ON, Canada.
Queen’s University. Department of Medicine. Kingston, ON, Canada.
University of Brasilia. Postgraduate Program in Tropical Medicine. Brasilia, DF, Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
Queen’s University. Department of Obstetrics and Gynecology. Kingston, ON, Canada / University. Department of Public Health Sciences. Kingston, ON, Canada.
Queen’s University. Bracken Health Sciences Library. Kingston, ON, Canada.
University Hospital of Martinique. Maison de la Femme, de la Mère et de l’Enfant. Centre Pluridisciplinaire de Diagnostic Prénatal de le Martinique. Fort-de-France, Martinique, France.
Altino Ventura Foundation. Department of Scientific Investigation. Recife, PE, Brazil.
Brazilian Ministry of Health. Brasilia, DF, Brazil.
University Hospital. Département “Femme-Mère Enfant”. Materno-fetal and Obstetrics Research Unit. Lausanne, Switzerland / Centre Hospitalier de l’Ouest Guyanais Franck Joly. Department of Obstetrics and Gynaecology. Saint-Laurent-du-Maroni, French Guiana.
Altino Ventura Foundation. Department of Pediatric Ophthalmology and Strabismus. Recife, PE, Brazil.
University of Hawaii at Manoa. John A. Burns School of Medicine. Department of Tropical Medicine, Medical Microbiology and Pharmacology. Honolulu, HI, USA.
University of Brasilia. Postgraduate Program in Tropical Medicine. Brasilia, DF, Brazil.
Queen’s University. Department of Obstetrics and Gynecology. Kingston, ON, Canada / University. Department of Public Health Sciences. Kingston, ON, Canada.
Resumen en ingles
Background: Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in
the fetus, the prognostic factors associated with this tragic disorder remain unclear. We conducted a systematic
review and meta-analysis to assess the prognostic factors associated with the incidence of microcephaly in
congenital ZIKV infection.
Methods: We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print,
Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS, and various thesis databases to
identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary
data from the authors of the included studies to calculate summary estimates and conduct the meta-analysis of the
most prevalent factors.
Results: We screened 4106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The
assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6154 newborns/
fetuses were enrolled; of those, 1120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were
diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological
findings in newborns/fetuses. Half of the studies provided primary data. Three out of 11 factors of interest seem to
be prognostic factors of microcephaly: infant’s sex – males compared to females: Relative Risk (RR) 1.30, 95%
Confidence Interval (95% CI) 1.14 to 1.49; the stage of pregnancy when infection occurred – infection in the first
trimester of pregnancy compared to infection at other stages of pregnancy: RR 1.41, 95% CI 1.09 to 1.82; and
asymptomatic infection compared to symptomatic infection during pregnancy: RR 0.68; 95% CI 0.60 to 0.77.
Conclusion: Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the
stage of pregnancy when ZIKV infection occurs. Continued surveillance of ZIKV infection during pregnancy is
needed to identify additional factors that could contribute to developing microcephaly in affected fetuses.
Palabras clave en ingles
Zika virusMicrocephaly
Pregnancy
Congenital disease
Risk factors
Systematic review
Congenital Zika syndrome
DeCS
Infecção por Zika vírusMicrocefalia
Transmissão Vertical de Doença Infecciosa
Revisão Sistemática
Compartir