Multiplex immune profiling of 69 inflammatory cytokines and chemokines using serum specimens derived from 14 LA healthy pregnant women (n = 4–5/trimester), 30 RJ healthy pregnant women (n = 10/trimester), and 30 ZIKV+ pregnant women (n = 10/trimester). (A) Heatmap and fold change of 16 inflammatory cytokines significantly upregulated in ZIKV+ women with abnormal birth compared with ZIKV+ women with normal birth. (B) IPA analysis of induced cytokines predicts cellular events associated with maternal-fetal cellular trafficking, inflammation, and tissue fibrosis. (C) Venn diagram representation of cytokines negatively/positively correlated to CCL2 expression in ZIKV+ pregnancy with normal or abnormal birth outcomes. (D) Increased CCL2/CD163, CCL2/TNFRSF1A, and CCL2/CCL22 ratios in ZIKV+ pregnancy with abnormal birth outcomes. Data (mean ± SEM) are presented in the box plot showing upper (75%) and lower (25%) quartiles, with horizontal line as median and whiskers as maximum and minimum values. *P < 0.05, Mann-Whitney U test. Median value of the ratios for LA healthy and RJ healthy controls is represented as blue dotted line and red dotted line, respectively.