Mortality from Congenital Zika Syndrome — Nationwide Cohort Study in Brazil

This population-based cohort study analyzed mortality risks among 11,481,215 live born children in Brazil (2015–2018), including 3,308 with congenital Zika syndrome (CZS). Children with CZS had a mortality rate of 52.6 deaths per 1,000 person years, 11.3 times higher than those without CZS (5.6 deaths per 1,000 person-years). The elevated risk persisted through the first 3 years of life, with the highest mortality rate ratio (21.9) observed after age 1. Term born infants with CZS faced a 14.3-fold higher mortality risk than unaffected peers. Leading causes of death included congenital anomalies, nervous system diseases, and infections. The study underscores the severe impact of CZS on child survival and highlights the need for preventive measures against Zika virus infection in pregnancy.

This population-based cohort study analyzed mortality risks among 11,481,215 live born children in Brazil (2015–2018), including 3,308 with congenital Zika syndrome (CZS). Children with CZS had a mortality rate of 52.6 deaths per 1,000 person years, 11.3 times higher than those without CZS (5.6 deaths per 1,000 person-years). The elevated risk persisted through the first 3 years of life, with the highest mortality rate ratio (21.9) observed after age 1. Term born infants with CZS faced a 14.3-fold higher mortality risk than unaffected peers. Leading causes of death included congenital anomalies, nervous system diseases, and infections. The study underscores the severe impact of CZS on child survival and highlights the need for preventive measures against Zika virus infection in pregnancy.