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The Zika virus (ZIKV) epidemic in Brazil and discovery of population level association between this infection and fetal microcephaly was the beginning of recognition of a public health emergency worldwide. Since then, epidemiological and pathogenesis research has strengthened the evidence of this link.1 ,2 The relative risk of congenital ZIKV among children of pregnant women who acquire this acute infection is an important epidemiological parameter, particularly for family planning reasons in endemic countries. This prospective cohort study describes the incidence and extent of fetal abnormalities as well as maternal clinical presentations among pregnant …