RAMB Março/Abril 2016

ika

virus

infection

and

pregnancy

ssoc

ras

2016; 62(2):108-115

111

FIGURE 1

Flowchart for study selection.

Eligibility

Included

Articles selected to be included in the guideline

n=30

identification

Pubmed/Medline

n=173

Embase

n=171

Articles selected for detailed reading of the full

text n=288

Studies excluded

because they were not

related to the

components of P.I.C.O.

(n=171); physiological

studies or animal

models (n=46); lack of

full text (n=41)

Duplicate articles n=56

Cochrane

n=0

vous system in Brazil, which is about five cases per 100,000

live births, less than the estimates recently made of 10 to

20 cases per 100,000 live births. This may indicate the oc-

currence of underreporting of microcephaly in the

country.

(

) Thus, any active search for this congenital

malformation would be able to increase its prevalence, with

a clear excess in the number of cases. Another point relat-

ed to the increase in the number of cases would be the

change in diagnostic criteria, accepting as microcephaly

cases of head circumference measuring less than 33 cm,

possibly explaining a situation of over-diagnosis. Another

relevant question, since the infection Zika virus in new-

borns and pregnant women were not confirmed by labo-

ratory tests at first, is that the history of nonspecific rash

referred to during pregnancy is subject to recall bias and

may have incurred potential misclassification regarding

exposure to Zika virus. Regardless of any controversies to

confirm, or not, the role of Zika virus in the genesis of cas-

es of microcephaly, measures to prevent infection with this

virus are necessary and unquestionable.