ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Children and Health
This article is part of the Research TopicThe effects on offspring by pregnancy diseases and pregnancy complicationsView all 4 articles
Interaction of Intrauterine Zika Virus Exposure on the Relationship Between Body Adiposity and Dyslipidemia in School-Aged Children
Provisionally accepted
Aline Ribeiro Murta*
Mariana de Santis Filgueiras
Cíntia Pereira DonateliMilena Sales Thomé
Rosângela Minardi Mitre Cotta
Tiago Ricardo MoreiraHercia Stampini Duarte MARTINOGlauce Dias da Costa- Universidade Federal de Vicosa, Viçosa, Brazil
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction/Objectives: Intrauterine exposure to the Zika virus (ZIKV) has been primarily associated with neurological outcomes, while its potential metabolic and nutritional consequences remain poorly understood. This study aimed to evaluate the association between anthropometric indicators body mass index (BMI)-for-age, waist circumference, and neck circumference and lipid profile al-terations in school-aged children born during the ZIKV epidemic. Methods: This retrospective cohort included 93 children aged 5–9 years (mean 6.5 ± 0.7 years; 58.1% boys) from the Belo Horizonte Region, Brazil. Participants were classified as exposed (59.1%) or unexposed to ZIKV in utero. Anthropometric measurements followed standardized protocols and included BMI-for-age, waist circumference, and neck circumference. Lipid profile assessment included total cholesterol, HDL-c, LDL-c, and triglycerides. Cardiovascular risk was estimated using Castelli indices I and II. Behavioral and sociodemographic factors, including screen time, caregiver education, and family income, were also recorded. Associations between anthropometric indicators and lipid outcomes were ana-lyzed using Poisson regression models with robust variance, including interaction terms to assess the modifying effect of ZIKV exposure. Results: Lipid abnormalities were common: low HDL-c (44.1%), high total cholesterol (33.3%), high LDL-c (26.9%), and high triglycerides (44.1%). Children exposed to ZIKV had a higher prevalence of low HDL-c compared with unexposed peers (54.6% vs. 29.0%; p = 0.015). BMI-for-age was inversely associated with low HDL-c (PR 0.87; 95% CI 0.78–0.97) and showed significant interactions with ZIKV exposure for total cholesterol (p interaction = 0.005) and triglycerides (p interaction = 0.008). Waist circumference interacted with ZIKV exposure regarding total cholesterol (p = 0.029; PR 1.09; 95% CI 1.03–1.16). Neck circumference was positively associated with total cholesterol, LDL-c, and triglycerides, with stronger associations among ZIKV-exposed children. Castelli Index I was higher in the exposed group (p = 0.0389), while Castelli Index II did not differ significantly (p = 0.1087). Conclusions: Intrauterine ZIKV exposure influences the relationship between adiposity and lipid profile in children. Central adiposity measures including waist circumference, neck circumference, and BMI—provide complementary information for early metabolic risk assessment. These findings highlight the importance of longitudinal monitoring of children exposed to ZIKV in utero to detect early metabolic alterations and guide preventive inter-ventions.
Keywords: Dyslipidemia, Obesity, Overweight, Thinness, Zika virus
Received: 29 Jul 2025; Accepted: 21 Jan 2026.
Copyright: © 2026 Murta, Filgueiras, Donateli, Thomé, Cotta, Moreira, MARTINO and Costa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aline Ribeiro Murta
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.