In late 2015, the Brazilian Ministry of Health and the Pan American Health Organization classified the increase in congenital malformations associated with the Zika virus (ZIKV) as a public health emergency. The risk of ZIKV-related congenital syndrome poses a threat to reproductive outcomes that could result in declining numbers of live births and potentially fertility. Using monthly microdata on live births from the Brazilian Information System on Live Births (SINASC), this study examines live births and fertility trends amid the ZIKV epidemic in Brazil. Findings suggest a decline in live births that is stratified across educational and geographic lines, beginning approximately nine months after the link between ZIKV and microcephaly was publicly announced. Although declines in total fertility rates were small, fertility trends estimated by age and maternal education suggest important differences in how Zika might have impacted Brazil’s fertility structure. Further findings confirm the significant declines in live births in mid-2016 even when characteristics of the municipality are controlled for; these results highlight important nuances in the timing and magnitude of the decline. Combined, our findings illustrate the value of understanding how the risk of a health threat directed at fetuses has led to declines in live births and fertility.

中文翻译：

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巴西寨卡疫情期间的活产和生育能力。


2015年底，巴西卫生部和泛美卫生组织将与寨卡病毒（ZIKV）相关的先天畸形增加列为突发公共卫生事件。寨卡病毒相关先天性综合症的风险对生殖结果构成威胁，可能导致活产数量和潜在生育能力下降。这项研究利用巴西活产信息系统 (SINASC) 的每月活产微观数据，研究了巴西 ZIKV 流行期间的活产和生育趋势。调查结果表明，在寨卡病毒与小头畸形之间的联系被公开宣布大约九个月后，不同教育和地区的活产率开始下降。尽管总生育率下降幅度较小，但根据年龄和孕产妇教育程度估算的生育趋势表明，寨卡病毒对巴西生育结构的影响可能存在重大差异。进一步的调查结果证实，即使控制了该市的特征，2016 年中期的活产率仍显着下降；这些结果凸显了下降时间和幅度上的重要细微差别。总而言之，我们的研究结果说明了了解针对胎儿的健康威胁风险如何导致活产率和生育率下降的价值。