Sanhueza-Sanzana Carlos, Kendall Carl, Allel Kasim, González Moisés Humberto Sandoval, Almeida Rosa Livia Freitas de, Aguiar Italo Wesley Oliveira, Dias Lívia Karla Sales, Pires Neto Roberto Justa da, Frota Cristiane Cunha, Correia Francisco Gustavo Silveira, Carvalho Francisco Herlânio Costa, Barreto Ivana Cristina de Holanda Cunha, Leal Marto, Vieira-Meyer Anya Pimentel Gomes Fernandes, Rutherford George, Kerr Ligia
Universidade Federal do Ceará, Department of Community Health - Fortaleza (CE), Brazil.
Tulane University, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Department of Social, Behavioral, and Population Sciences - New Orleans, United States of America.
Rev Bras Epidemiol. 2025 Aug 8;28:e250044. doi: 10.1590/1980-549720250044. eCollection 2025.
To explore the association between the Zika virus epidemic, fertility rates, and sociodemographic and behavioral factors influencing birth trends.
A prospective cohort of 1,497 women aged between 15 and 39 years living in arbovirus-endemic areas in Fortaleza, Brazil, was analyzed. Women were enrolled in February 2018 and followed up two times every six months. The total fertility rate (TFR), age-specific fertility rate (ASFR), and mean age at first birth (MAB) were estimated and a multivariate Poisson regression model was used to explore the main factors associated with fertility.
The TFR was lowest during the epidemic period (2.64, 95%CI 2.06-3.06), increasing in the post-epidemic phase (TFR=3.52, 95%CI 3.18-3.86). Low educational attainment (RR=1.32, TFR=3.69, 95%CI 3.26-4.13), overcrowding (RR=1.27, TFR=3.26, 95%CI 2.98-3.54), and having undergone an abortion (RR=1.85, TFR=4.88, 95%CI 4.31-5.45) were associated with higher fertility rates. Conversely, having had an unwanted pregnancy was associated with reduced fertility (RR=0.81, TFR=2.65, 95%CI 2.41-2.89).
We observed a slowdown in fertility rates during the epidemic period coincident with human Zika virus transmission with large differences by sociodemographic gradients.
探讨寨卡病毒流行、生育率以及影响出生趋势的社会人口学和行为因素之间的关联。
对居住在巴西福塔雷萨虫媒病毒流行地区的1497名年龄在15至39岁之间的女性进行前瞻性队列分析。这些女性于2018年2月入组，每六个月随访两次。估计了总生育率（TFR）、年龄别生育率（ASFR）和初产平均年龄（MAB），并使用多变量泊松回归模型探讨与生育相关的主要因素。
在流行期间总生育率最低（2.64，95%置信区间2.06 - 3.06），在流行后期有所上升（TFR = 3.52，95%置信区间3.18 - 3.86）。低教育程度（相对风险 = 1.32，TFR = 3.69，95%置信区间3.26 - 4.13）、居住拥挤（相对风险 = 1.27，TFR = 3.26，95%置信区间2.98 - 3.54）以及曾有过堕胎经历（相对风险 = 1.85，TFR = 4.88，95%置信区间4.31 - 5.45）与较高的生育率相关。相反，意外怀孕与生育率降低相关（相对风险 = 0.81，TFR = 2.65，95%置信区间2.41 - 2.89）。
我们观察到在流行期间生育率下降，这与寨卡病毒在人群中的传播同时发生，且存在社会人口学梯度的巨大差异。
