Zika virus epidemics have potential large-scale population effects. Controlled studies of mice and nonhuman primates indicate that Zika affects fecundity, raising concerns about miscarriage in human populations. In regions of Brazil, Zika risk peaked months before residents learned about the epidemic and its relation to congenital anomalies. This spatiotemporal variation supports analysis of both biological effects of Zika infection on fertility and the effects of learning about Zika risk on reproductive behavior. Causal inference techniques used with vital statistics indicate that the epidemic caused reductions in birth cohort size of approximately one-quarter 18 months after Zika infection risk peaked but 10 months after public health messages advocated childbearing delay. The evidence is consistent with small but not statistically detectable biological reductions in fecundity, as well as large strategic changes in reproductive behavior to temporally align childbearing with reduced risk to infant health. The behavioral effects are larger for more-educated and older women, which may reflect facilitated access to information and to family planning services within high-risk, mosquito-infested urban locations as well as perceptions about the opportunity costs of risks to pregnancy and infant survival.

中文翻译：

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巴西失踪婴儿：寨卡风险改变生殖行为。


寨卡病毒流行可能会对大规模人口产生影响。对小鼠和非人类灵长类动物的对照研究表明，寨卡病毒会影响繁殖力，引发人们对人类流产的担忧。在巴西的一些地区，寨卡病毒的风险在居民了解这种流行病及其与先天异常的关系之前几个月就达到了顶峰。这种时空变化支持分析寨卡病毒感染对生育力的生物学影响以及了解寨卡病毒风险对生殖行为的影响。与生命统计数据结合使用的因果推断技术表明，在寨卡感染风险达到顶峰后的 18 个月、公共卫生信息提倡延迟生育的 10 个月后，该流行病导致出生队列规模减少约四分之一。这些证据与生育力的小幅但统计上无法检测到的生物学下降以及生殖行为的重大战略变化一致，以暂时使生育与婴儿健康风险降低保持一致。对于受教育程度较高和年龄较大的女性来说，行为影响更大，这可能反映了在高风险、蚊子出没的城市地区获得信息和计划生育服务的便利性，以及对怀孕和婴儿生存风险的机会成本的看法。