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Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil
While it is well known that socioeconomic markers are associated with a higher risk of arbovirus infections, research on the relationship between socioeconomic factors and congenital Zika syndrome (CZS) remains limited. This study investigates the relationship between socioeconomic risk markers and...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528618/ https://www.ncbi.nlm.nih.gov/pubmed/36175039 http://dx.doi.org/10.1136/bmjgh-2022-009600 |
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author | Paixão, Enny S Fernandes, Qeren Hapuk R Ferreira Cardim, Luciana L Pescarini, Julia M Costa, Maria Conceicao N Falcão, Ila R Brickley, Elizabeth B Santos, Andreia Costa Portela Souza, André Carvalho-Sauer, Rita de Cassia Oliveira Smeeth, Liam Rodrigues, Laura C Barreto, Mauricio L Teixeira, Maria Gloria |
author_facet | Paixão, Enny S Fernandes, Qeren Hapuk R Ferreira Cardim, Luciana L Pescarini, Julia M Costa, Maria Conceicao N Falcão, Ila R Brickley, Elizabeth B Santos, Andreia Costa Portela Souza, André Carvalho-Sauer, Rita de Cassia Oliveira Smeeth, Liam Rodrigues, Laura C Barreto, Mauricio L Teixeira, Maria Gloria |
author_sort | Paixão, Enny S |
collection | PubMed |
description | While it is well known that socioeconomic markers are associated with a higher risk of arbovirus infections, research on the relationship between socioeconomic factors and congenital Zika syndrome (CZS) remains limited. This study investigates the relationship between socioeconomic risk markers and live births with CZS in Brazil. We conducted a population-based study using data from all registered live births in Brazil (Live Births Information System) linked with the Public Health Event Record from 1 January 2015 to 31 December 2018. We used logistic regression models to estimate the OR and 95% CIs of CZS based on a three-level framework. In an analysis of 11 366 686 live births, of which 3353 had CZS, we observed that live births of self-identified black or mixed race/brown mothers (1.72 (95% CI 1.47 to 2.01) and 1.37 (95% CI 1.24 to 1.51)) were associated with a higher odds of CZS. Live births from single women compared with married women and those from women with less than 12 years of education compared with those with more than 12 years of education also had higher odds of CZS. In addition, live births following fewer prenatal care appointments had increased odds of CZS in the nationwide data. However, in the analyses conducted in the Northeast region (where the microcephaly epidemic started before the link with Zika virus was established and before preventive measures were known or disseminated), no statistical association was found between the number of prenatal care appointments and the odds of CZS. This study shows that live births of the most socially vulnerable women in Brazil had the greatest odds of CZS. This disproportionate distribution of risk places an even greater burden on already socioeconomically disadvantaged groups, and the lifelong disabilities caused by this syndrome may reinforce existing social and health inequalities. |
format | Online Article Text |
id | pubmed-9528618 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-95286182022-10-04 Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil Paixão, Enny S Fernandes, Qeren Hapuk R Ferreira Cardim, Luciana L Pescarini, Julia M Costa, Maria Conceicao N Falcão, Ila R Brickley, Elizabeth B Santos, Andreia Costa Portela Souza, André Carvalho-Sauer, Rita de Cassia Oliveira Smeeth, Liam Rodrigues, Laura C Barreto, Mauricio L Teixeira, Maria Gloria BMJ Glob Health Original Research While it is well known that socioeconomic markers are associated with a higher risk of arbovirus infections, research on the relationship between socioeconomic factors and congenital Zika syndrome (CZS) remains limited. This study investigates the relationship between socioeconomic risk markers and live births with CZS in Brazil. We conducted a population-based study using data from all registered live births in Brazil (Live Births Information System) linked with the Public Health Event Record from 1 January 2015 to 31 December 2018. We used logistic regression models to estimate the OR and 95% CIs of CZS based on a three-level framework. In an analysis of 11 366 686 live births, of which 3353 had CZS, we observed that live births of self-identified black or mixed race/brown mothers (1.72 (95% CI 1.47 to 2.01) and 1.37 (95% CI 1.24 to 1.51)) were associated with a higher odds of CZS. Live births from single women compared with married women and those from women with less than 12 years of education compared with those with more than 12 years of education also had higher odds of CZS. In addition, live births following fewer prenatal care appointments had increased odds of CZS in the nationwide data. However, in the analyses conducted in the Northeast region (where the microcephaly epidemic started before the link with Zika virus was established and before preventive measures were known or disseminated), no statistical association was found between the number of prenatal care appointments and the odds of CZS. This study shows that live births of the most socially vulnerable women in Brazil had the greatest odds of CZS. This disproportionate distribution of risk places an even greater burden on already socioeconomically disadvantaged groups, and the lifelong disabilities caused by this syndrome may reinforce existing social and health inequalities. BMJ Publishing Group 2022-09-29 /pmc/articles/PMC9528618/ /pubmed/36175039 http://dx.doi.org/10.1136/bmjgh-2022-009600 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Research Paixão, Enny S Fernandes, Qeren Hapuk R Ferreira Cardim, Luciana L Pescarini, Julia M Costa, Maria Conceicao N Falcão, Ila R Brickley, Elizabeth B Santos, Andreia Costa Portela Souza, André Carvalho-Sauer, Rita de Cassia Oliveira Smeeth, Liam Rodrigues, Laura C Barreto, Mauricio L Teixeira, Maria Gloria Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil |
title | Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil |
title_full | Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil |
title_fullStr | Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil |
title_full_unstemmed | Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil |
title_short | Socioeconomic risk markers of congenital Zika syndrome: a nationwide, registry-based study in Brazil |
title_sort | socioeconomic risk markers of congenital zika syndrome: a nationwide, registry-based study in brazil |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528618/ https://www.ncbi.nlm.nih.gov/pubmed/36175039 http://dx.doi.org/10.1136/bmjgh-2022-009600 |
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