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妊娠期母体 Zika 病毒感染与胎儿、新生儿和婴儿结局的关系：系统评价和荟萃分析。

Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis.

机构信息

Department of Pediatrics, Martagão Gesteira Institute of Childcare and Pediatrics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Department of Pediatrics, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

PLoS One. 2021 Feb 19;16(2):e0246643. doi: 10.1371/journal.pone.0246643. eCollection 2021.

DOI:10.1371/journal.pone.0246643
PMID:33606729
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7894820/
Abstract

The occurrence of fetal and neonatal disorders in pregnant women with Zika virus infection in the literature is not consistent. This study aims to estimate the prevalence rate of these disorders in fetuses/neonates of pregnant women with confirmed or probable infection by Zika virus. A systematic review with meta-analysis was conducted in November 2020. Cohort studies that contained primary data on the prevalence of unfavorable outcomes in fetuses or neonates of women with confirmed or probable Zika virus infection during pregnancy were included. A total of 21 cohort studies were included, with a total of 35,568 pregnant women. The meta-analysis showed that central nervous system abnormalities had the highest prevalence ratio of 0.06 (95% CI 0.03-0.09). Intracranial calcifications had a prevalence ratio of 0.01 (95% CI 0.01-0.02), and ventriculomegaly 0.01 (95% CI 0.01-0.02). The prevalence ratio of microcephaly was 0.03 (95% CI 0.02-0.05), fetal loss (miscarriage and stillbirth) was 0.04 (95% CI 0.02-0.06), Small for Gestational Age was 0.04 (95% CI 0.00-0,09), Low Birth Weight was 0.05 (95% CI 0.03-0.08) and Prematurity was 0.07 (95% CI 0.04-0.10). The positivity in RT-PCR for ZIKV performed in neonates born to infected mothers during pregnancy was 0.25 (95% CI 0.06-0.44). We also performed the meta-analysis of meta-analysis for microcephaly with the prevalence ratios from other two previously systematic reviews: 0.03 (95% CI 0.00-0.25). Our results contribute to measuring the impact of Zika virus infection during pregnancy on children's health. The continuous knowledge of this magnitude is essential for the implementation development of health initiatives and programs, in addition to promoting disease prevention, especially in the development of a vaccine for Zika virus. PROSPERO protocol registration: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019125543.

摘要

文献中寨卡病毒感染孕妇所生胎儿/新生儿疾病的发生率并不一致。本研究旨在评估经实验室确诊或疑似寨卡病毒感染孕妇所生胎儿/新生儿不良结局的发生率。2020 年 11 月进行了系统评价和荟萃分析。纳入了包含孕妇确诊或疑似寨卡病毒感染后胎儿或新生儿不良结局发生率的原始数据的队列研究。共纳入 21 项队列研究，共 35568 名孕妇。荟萃分析显示，中枢神经系统异常的患病率比最高，为 0.06（95%CI 0.03-0.09）。颅内钙化的患病率比为 0.01（95%CI 0.01-0.02），脑室扩大为 0.01（95%CI 0.01-0.02）。小头畸形的患病率比为 0.03（95%CI 0.02-0.05），胎儿丢失（流产和死产）为 0.04（95%CI 0.02-0.06），小于胎龄儿为 0.04（95%CI 0.00-0.09），低出生体重为 0.05（95%CI 0.03-0.08），早产为 0.07（95%CI 0.04-0.10）。母亲在孕期感染寨卡病毒的新生儿中，用 RT-PCR 检测寨卡病毒阳性的比例为 0.25（95%CI 0.06-0.44）。我们还对另两项系统评价中的小头畸形患病率比进行了荟萃分析荟萃分析，结果为 0.03（95%CI 0.00-0.25）。我们的研究结果有助于衡量寨卡病毒感染对儿童健康的影响。持续了解这一情况对于制定和实施卫生倡议和方案至关重要，此外还可以促进疾病预防，特别是寨卡病毒疫苗的研发。PROSPERO 方案注册：http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019125543。

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