In:

The Lancet

Authors:

Dr Thalia Velho Barreto de Araújo, PhD, Prof Laura Cunha Rodrigues, PhD, Prof Ricardo Arraes de Alencar Ximenes, PhD, Demócrito de Barros Miranda-Filho, PhD, Ulisses Ramos Montarroyos, PhD, Ana Paula Lopes de Melo, MSc, Sandra Valongueiro, PhD, Maria de Fátima Pessoa Militão de Albuquerque, PhD, Wayner Vieira Souza, PhD, Cynthia Braga, PhD, Sinval Pinto Brandão Filho, PhD, Marli Tenório Cordeiro, PhD, Enrique Vazquez, PhD, Danielle Di Cavalcanti Souza Cruz, MD, Cláudio Maierovitch Pessanha Henriques, MSc, Luciana Caroline Albuquerque Bezerra, MSc, Priscila Mayrelle da Silva Castanha, PhD, Rafael Dhalia, PhD, Ernesto Torres Azevedo Marques-Júnior, PhD, Prof Celina Maria Turchi Martelli, PhD

Background
The microcephaly epidemic, which started in Brazil in 2015, was declared a Public Health Emergency of International Concern by WHO in 2016. We report the preliminary results of a case-control study investigating the association between microcephaly and Zika virus infection during pregnancy.

Methods
We did this case-control study in eight public hospitals in Recife, Brazil. Cases were neonates with microcephaly. Two controls (neonates without microcephaly), matched by expected date of delivery and area of residence, were selected for each case. Serum samples of cases and controls and cerebrospinal fluid samples of cases were tested for Zika virus-specific IgM and by quantitative RT-PCR. Laboratory-confirmed Zika virus infection during pregnancy was defined as detection of Zika virus-specific IgM or a positive RT-PCR result in neonates. Maternal serum samples were tested by plaque reduction neutralisation assay for Zika virus and dengue virus. We estimated crude odds ratios (ORs) and 95% CIs using a median unbiased estimator for binary data in an unconditional logistic regression model. We estimated ORs separately for cases with and without radiological evidence of brain abnormalities.

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