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Canadian Journal of Public Health

, Volume 110, Issue 5, pp 638–648 | Cite as

Maternal infection with Zika virus and prevalence of congenital disorders in infants: systematic review and meta-analysis

  • Saiee F. Nithiyanantham
  • Alaa BadawiEmail author
Systematic Review

Abstract

Objective

Zika virus (ZIKV) infection is a vector-borne disease that can be transmitted sexually and vertically. The vertical transmission of the virus may lead to congenital Zika syndrome in infants. The aim of this study is to conduct a systematic review and meta-analysis of published reports documenting the prevalence of congenital Zika-related disorders in infants of mothers infected with ZIKV during pregnancy.

Methods

We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic and Web of Science databases to identify human studies reporting prevalence of congenital disorders in infants of ZIKV-infected mothers.

Results

We identified 25 reports selected for inclusion in the current study (n = 4683 subjects). The majority of the studies were from South American high-risk countries. Only one third of the identified studies were conducted in the United States. Clinical maternal symptoms included maculopapular rash (76.9%), arthralgia (46.4%), fever (45.5%) and headache (31.8%) with myalgia and conjunctivitis only presented in 25% of the cases. The most prevalent congenital disorder in the newborns was brain calcifications (42.6; 95% CI, 30.8–54.4), followed by ventriculomegaly (21.8; 95% CI, 15.2–28.4), joint abnormalities (13.2; 95% CI, 9.4–18.2), ocular abnormalities (4.2; 95% CI, 1.0–7.5) and microcephaly (3.9; 95% CI, 2.4–5.4).

Conclusion

The current study highlights the high prevalence of a range of congenital disorders in newborns of mothers infected with ZIKV. It warrants developing studies to further clarify the mechanisms by which each of these disorders occurs in response to the viral infection during pregnancy and its vertical transmission to the infants.

Keywords

Zika virus Microcephaly Congenital disease Brain calcification Systematic review 

Résumé

Objectif

L'infection par le virus Zika (ZIKV) est une maladie à vecteur pouvant être transmise sexuellement et verticalement. La transmission verticale du virus peut entraîner un syndrome congénital de Zika chez les nourrissons. Le but de cette étude est de réaliser une revue systématique et une méta-analyse de rapports publiés documentant la prévalence de troubles congénitaux liés au Zika chez les nourrissons de mères infectées par le ZIKV pendant la grossesse.

Méthodes

Nous avons effectué une recherche exhaustive dans les bases de données Ovid MEDLINE, Ovid MEDLINE (R) avant impression, Embase, Embase Classic et Web of Science afin d'identifier des études humaines rapportant la prévalence de troubles congénitaux chez les nourrissons de mères infectées par le ZIKV.

Résultats

Nous avons identifié 25 rapports sélectionnés pour inclusion dans la présente étude (n = 4 683 sujets). La majorité des études ont été réalisées dans des pays d'Amérique du Sud présentant un risque élevé. Seulement un tiers des études identifiées ont été menées aux États-Unis. Les symptômes maternels cliniques incluaient une éruption maculo-papuleuse (76,9 %), une arthralgie (46,4 %), une fièvre (45,5 %) et des maux de tête (31,8 %) avec myalgie et conjonctivite ne se présentant que dans 25 % des cas. Les troubles congénitaux les plus fréquents chez les nouveau-nés étaient les calcifications cérébrales (42,6, IC à 95% : 30,8–54,4), suivies par la ventriculomégalie (21,8, IC à 95% : 15,2–28,4), les anomalies articulaires (13,2, IC à 95% : 9,4–18,2), des anomalies oculaires (4,2, IC à 95% : 1,0–7,5) et une microcéphalie (3,9, IC à 95% : 2,4–5,4).

Conclusion

La présente étude met en évidence la prévalence élevée d'une gamme de troubles congénitaux chez les nouveau-nés de mères infectées par le ZIKV. Cela justifie de développer des études pour préciser davantage les mécanismes par lesquels chacun de ces troubles se produit en réponse à l’infection virale pendant la grossesse et à sa transmission verticale aux nourrissons.

Mots-clés

Virus Zika Microcéphalie Maladie congénitale Calcification du cerveau Revue systématique 

Notes

Acknowledgements

This work was supported by the Public Health Agency of Canada (AB). The authors thank Mr. S.G. Ryoo for assistance with abstract selection, full-text screening and data analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

41997_2019_215_MOESM1_ESM.docx (27 kb)
ESM 1 (DOCX 22 kb)

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Copyright information

© The Canadian Public Health Association 2019

Authors and Affiliations

  1. 1.Faculty of Arts and ScienceUniversity of TorontoTorontoCanada
  2. 2.Public Health Risk Sciences DivisionPublic Health Agency of CanadaTorontoCanada
  3. 3.Department of Nutritional Sciences, Faculty of MedicineUniversity of TorontoTorontoCanada

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