Another piece on the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis.
Bibliographic record
Abstract
Abstract Background: Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the foetus, the risk factors associated to this tragic disorder remain unclear. We conducted a systematic review and meta-analysis toto assess risk factors associated with the incidence of microcephaly in congenital ZIKV infection. Methods: We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from authors of the studies included in this review to calculate summary estimates and conduct meta-analysis of the most prevalent factors. Results: We screened 4,106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6,154 children/foetuses were enrolled; of those, 1,120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in foetuses/ children. Half of the studies provided primary data. Two out of eleven factors of interest were associated with microcephaly: infant’s sex – males presented a higher risk of microcephaly compared to females (RR 1.30, 95% CI 1.14, 1.49); and the stage of pregnancy when infection occurred - infection in the first trimester of pregnancy had a higher risk of microcephaly (RR 1.41, 95% CI 1.09 to 1.82), compared to infection at other stages of pregnancy. Conclusion: Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when Zika virus infection occurs. Continued surveillance of ZIKV during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected foetuses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.042 | 0.109 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.037 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".