What is it about?

The emerging Zika virus (ZIKV) infection may lead to congenital microcephaly, miscarriage, and stillbirth in pregnant women. Here, we developed two mouse models of maternal-fetal (in utero) transmission of ZIKV and observed fetal demise, poor fetal development, stillbirth, and low body weight of the litters. Notably, ZIKV greatly reduced the level of maternal serum folic acid (FA), an essential water-soluble vitamin B required for placental and fetal development. This lead us to speculate the beneficial effect of FA treatment to improve the clinical presentations of in utero transmission of ZIKV. We found treatment with FA reduced pathological features in the placenta, number of fetal demise, and stillbirths. Moreover, mice with FA treatment showed lower viral burden, reduced inflammatory response, and enhanced integrity of blood-placenta barrier. Overall, our findings suggest the preventive role of FA supplementation in ZIKV-associated abnormal pregnancy.

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Why is it important?

ZIKV infection during pregnancy possess an increased risk of fetal growth restriction in human. Vaccine and antiviral drugs against ZIKV are ongoing; therefore, in the meantime, preventing in utero transmission of ZIKV is critical. Notably, this study may serve as a scientific reference for stakeholders and policy makers in public health to evaluate maternal FA status and revitalize FA supplementation program among women at childbearing in areas with active ZIKV transmission.


The interplay between micronutrients and virus infection is largely neglected. As a virologist with nutrition background, it is fascinating to learn virus-associated nutritional deficiency that, in turn, leads us to a nutritional intervention for improving the disease prognosis.

Yogy Simanjuntak
Academia Sinica

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This page is a summary of: Preventive effects of folic acid on Zika virus-associated poor pregnancy outcomes in immunocompromised mice, PLoS Pathogens, May 2020, PLOS,
DOI: 10.1371/journal.ppat.1008521.
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