Ba Fang, Li Hui, Ding Silu, Guo Tingyi, Zhang Junmei, Sun Yanli
Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Gynecology, The First Hospital of Chinese Medical University, Shenyang, China.
Rev Med Virol. 2025 Mar;35(2):e70019. doi: 10.1002/rmv.70019.
Zika virus (ZIKV) is a virus transmitted by arthropods that exhibits considerable pathogenicity, resulting in a significant health and economic impact worldwide. A rise in congenital anomalies has been noted in kids born to mothers who have infections during pregnancy, alongside a rise in neurological symptoms in adults. In this study, we reassessed the data on brain abnormalities in maternal infection with ZIKV during pregnancy through a systematic review and meta-analysis. A thorough search was carried out in the PubMed, Scopus, Web of Science and Embase databases to extract pertinent published data up to November, 2024. In this meta-analysis, 14 studies with 912 individuals were incorporated. Subgroup analyses, depending on the maternal age, gestational age at detection of brain abnormalities, the time of ZIKV diagnosis, type of sample and birth weight at delivery, were performed. Critical appraisal was completed using the Newcastle-Ottawa Scale (NOS) tools. In this analysis, we identified 14 studies that reported brain abnormalities in newborn infants with ZIKV-infected pregnant women, of which 58% studies were from Brazil. The overall birth defect with brain abnormalities was found to be (1.94 [95% CI: 1.3-2.7], P = 0.00). Of the most common brain abnormalities, microcephaly (OR: 2.7 [95% CI 1.5-4.7], P = 0.00), ventriculomegaly (OR: 1.7 [95% CI 0.91-3.3], P = 0.09) and corpus callosal anomaly (OR: 1.8 [95% CI 1.02-3.3], P = 0.04) had highest the risk in children with ZIKV-infected pregnant women. No publication bias was found when applying the Begg's rank correlation and Egger's linear regression tests (P = 1 and P = 0.44, respectively). subgroups of maternal age ≥ 30 years and gestational week of ZIKV diagnosis ≥ 25 weeks are important in zika-associated birth defects. This systematic review and meta-analysis evidenced a high risk of brain defects in ZIKV-infected pregnant women. Maternal age and gestational week of ZIKV diagnosis may modify this risk.
寨卡病毒（ZIKV）是一种由节肢动物传播的病毒，具有相当高的致病性，在全球范围内对健康和经济造成了重大影响。已注意到，孕期感染该病毒的母亲所生儿童的先天性异常有所增加，同时成人的神经症状也有所增加。在本研究中，我们通过系统评价和荟萃分析重新评估了孕期感染寨卡病毒的母亲出现脑部异常的数据。我们在PubMed、Scopus、科学网和Embase数据库中进行了全面检索，以提取截至2024年11月的相关已发表数据。在这项荟萃分析中，纳入了14项研究，共912名个体。根据母亲年龄、检测到脑部异常时的孕周、寨卡病毒诊断时间、样本类型和分娩时的出生体重进行了亚组分析。使用纽卡斯尔-渥太华量表（NOS）工具完成了关键评估。在该分析中，我们确定了14项报告寨卡病毒感染孕妇所生新生儿脑部异常的研究，其中58%的研究来自巴西。发现伴有脑部异常的总体出生缺陷为（1.94 [95% CI：1.3 - 2.7]，P = 0.00）。在最常见的脑部异常中，小头畸形（OR：2.7 [95% CI 1.5 - 4.7]，P = 0.00）、脑室扩大（OR：1.7 [95% CI 0.91 - 3.3]，P = 0.09）和胼胝体异常（OR：1.8 [95% CI 1.02 - 3.3]，P = 0.04）在寨卡病毒感染孕妇所生儿童中的风险最高。应用Begg秩相关检验和Egger线性回归检验时未发现发表偏倚（P分别为1和0.44）。母亲年龄≥30岁和寨卡病毒诊断孕周≥25周的亚组在寨卡病毒相关出生缺陷中很重要。这项系统评价和荟萃分析证明寨卡病毒感染孕妇出现脑部缺陷的风险很高。母亲年龄和寨卡病毒诊断孕周可能会改变这种风险。
