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Brazil, hit hard by the Zika pandemic, also maintains a national registry of key health indicators. Investigators conducted a retrospective, population-based cohort study of linked data on >11.7 million live-born children in Brazil between 2015 and 2018, a period of high Zika transmission in the Americas. These children were followed until age 3 years, death, or the end of 2018.
Among 3308 live-born children with congenital Zika syndrome (CZS), 20% were born preterm and 36% had low birthweight. Through 36 months, live-born children with CZS had mortality 11 times higher than children without CZS (52.6 vs. 5.6 deaths/1000 person-years). Even in live-born children with CZS born at term or with normal birth weight, mortality was 12 times higher…