Congenital Zika syndrome: A systematic review

PLoS One. 2020 Dec 15;15(12):e0242367. doi: 10.1371/journal.pone.0242367. eCollection 2020.


Background: The signs and symptoms of Zika virus infection are usually mild and self-limited. However, the disease has been linked to neurological complications such as Guillain-Barré syndrome and peripheral nerve involvement, and also to abortion and fetal deaths due to vertical transmission, resulting in various congenital malformations in newborns, including microcephaly. This review aimed to describe the o signs and symptoms that characterize the congenital Zika syndrome.

Methods and findings: A systematic review was performed with a protocol and described according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search strategy yielded 2,048 studies. After the exclusion of duplicates and application of inclusion criteria, 46 studies were included. The main signs and symptoms associated with the congenital Zika syndrome were microcephaly, parenchymal or cerebellar calcifications, ventriculomegaly, central nervous system hypoplasia or atrophy, arthrogryposis, ocular findings in the posterior and anterior segments, abnormal visual function and low birthweight for gestational age.

Conclusions: Zika virus infection during pregnancy can cause a series of changes in the growth and development of children, while impacting the healthcare system due to the severity of cases. Our findings outline the disease profile in newborns and infants and may contribute to the development and updating of more specific clinical protocols.

Publication types

  • Systematic Review

MeSH terms

  • Child Development / physiology
  • Female
  • Guillain-Barre Syndrome / diagnosis*
  • Guillain-Barre Syndrome / virology
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*
  • Nervous System Malformations / diagnosis*
  • Nervous System Malformations / physiopathology
  • Nervous System Malformations / virology
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • Syndrome
  • Zika Virus / pathogenicity
  • Zika Virus Infection / complications
  • Zika Virus Infection / congenital
  • Zika Virus Infection / transmission*
  • Zika Virus Infection / virology

Grants and funding

The author(s) received no specific funding for this work.