Babies born with congenital Zika syndrome (CZS), due to infection with the Zika virus during pregnancy, are at more than 11x greater risk of dying during the first three years of life than those born without the syndrome, according to a new study.

Of nearly 11.5 million live births in Brazil, 3,308 babies were born with confirmed or probable CZS — of which 12% (398) died during the study period. In comparison, of the over 11.4 million babies born without CZS, 1% (120,629) babies died during the study period.

The study was carried out by a joint team from the London School of Hygiene & Tropical Medicine (LSHTM), the Center of Data and Knowledge Integration for Health (CIDAS-Fiocruz) and the Federal University of Bahia (UFBA), funded by Wellcome and the Brazilian Ministry of Health.

The study found the mortality rate among live births with CZS was over 11x higher than among live births without CZS up to the age of 36 months.

Normally babies who are born prematurely or small are at greater risk of death. In contrast, in babies born with CZS, the highest risk was found to be for children who were carried to full term or at normal birth weight (over 5.5lbs) — 14.3x higher and 12.9x higher than babies in that group born without CZS, respectively.

The main causes of death amongst babies born with CZS were infectious diseases, diseases of the nervous systems, and congenital abnormalities — mainly sepsis, cerebral palsy and microcephaly, respectively.

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Materials provided by London School of Hygiene & Tropical Medicine. Note: Content may be edited for style and length.