Risk of Zika microcephaly correlates with features of maternal antibodies

Davide F. Robbiani, Priscilla C. Olsen, Federico Costa, Qiao Wang, Thiago Y. Oliveira, Nivison Nery, Adeolu Aromolaran, Mateus S. do Rosário, Gielson A. Sacramento, Jaqueline S. Cruz, Ricardo Khouri, Elsio A. Wunder, Adriana Mattos, Bruno de Paula Freitas, Manoel Sarno, Gracinda Archanjo, Dina Daltro, Gustavo B.S. Carvalho, Kleber Pimentel, Isadora C. de SiqueiraJoão R.M. de Almeida, Daniele F. Henriques, Juliana A. Lima, Pedro F.C. Vasconcelos, Dennis Schaefer-Babajew, Stephanie A. Azzopardi, Leonia Bozzacco, Anna Gazumyan, Rubens Belfort, Ana P. Alcântara, Gustavo Carvalho, Licia Moreira, Katiaci Araujo, Mitermayer G. Reis, Rebekah I. Keesler, Lark L. Coffey, Jennifer Tisoncik-Go, Michael Gale, Lakshmi Rajagopal, Kristina M. Adams Waldorf, Dawn M. Dudley, Heather A. Simmons, Andres Mejia, David H. O’Connor, Rosemary J. Steinbach, Nicole Haese, Jessica Smith, Anne Lewis, Lois Colgin, Victoria Roberts, Antonio Frias, Meredith Kelleher, Alec Hirsch, Daniel N. Streblow, Charles M. Rice, Margaret R. MacDonald, Antonio R.P. de Almeida, Koen K.A. van Rompay, Albert I. Ko, Michel C. Nussenzweig

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Zika virus (ZIKV) infection during pregnancy causes congenital abnormalities, including microcephaly. However, rates vary widely, and the contributing risk factors remain unclear. We examined the serum antibody response to ZIKV and other flaviviruses in Brazilian women giving birth during the 2015–2016 outbreak. Infected pregnancies with intermediate or higher ZIKV antibody enhancement titers were at increased risk to give birth to microcephalic infants compared with those with lower titers (P < 0.0001). Similarly, analysis of ZIKV-infected pregnant macaques revealed that fetal brain damage was more frequent in mothers with higher enhancement titers. Thus, features of the maternal antibodies are associated with and may contribute to the genesis of ZIKV-associated microcephaly.

Original languageEnglish (US)
Pages (from-to)2302-2315
Number of pages14
JournalJournal of Experimental Medicine
Issue number10
StatePublished - Oct 1 2019

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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