Main Findings
We aimed to investigate adverse pregnancy and early neonatal outcomes
according to gestational age of maternal infection in all 511 notified
ZIKV-infected women and their offspring from one of the most affected
Brazilian regions. Most pregnancies evolved uneventfully. Pregnancy
losses occurred in 4.7% of cases, and abnormalities potentially related
to ZIKV infection in 25.0% of the stillbirths and 3.9% of the
live-born infants. The typical CZS phenotype occurred in 2.9% of
infants (CI95%:1.7-4.7) without comorbidities. As other congenital
infections, the ZIKV congenital disease had a broad spectrum with
possible subclinical findings. Apparently asymptomatic infants
thoroughly evaluated within 3 months of age had ZIKV-related eye
abnormalities (1.3%), significant imaging brain abnormalities (0.5%),
and potential neurologic/neurodevelopment dysfunctions (8.0%).
Furthermore, early (< 11 weeks of gestation) ZIKV
maternal infection was strongly associated with the presence of severe
neurological impairment.