Pregnant women infected with the Zika virus are 20 times more likely to have a baby born with certain birth defects as mothers who gave birth before the Zika epidemic began, U.S. health officials reported Thursday.

Even worse, “when you look just at brain abnormalities and microcephaly, what we are seeing is more than 30 times higher than the prevalence before Zika was introduced to the Americas,” said Margaret Honein. She is chief of the birth defects branch at the U.S. Centers for Disease Control and Prevention.

With microcephaly, babies are born with a smaller-than-normal head and an underdeveloped brain. Since the mosquito-borne virus first began to spread through South America in April 2015, thousands of babies have been born with Zika-linked microcephaly. The large majority have been born in Brazil, but the consequences of Zika infection during pregnancy are now being seen in the United States.

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