Zika increases the risk of microcephaly -- an otherwise rare condition that results in an abnormally small head -- by fifty-fold, the researchers calculated.
"The first trimester is the most critical," lead author Simon Cauchemez, a scientist at the Institut Pasteur in Paris, told AFP.
His team's statistical analysis of a Zika outbreak in French Polynesia in 2013-14 that spread to two-thirds of the population is the most rigorous attempt yet to quantify the risk of microcephaly, which emerges in foetuses.
One study from Brazil estimated the chance of birth defects for mothers carrying the virus during pregnancy at more than 20 percent, but carried a very large margin of error.
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All told, some 40 countries have reported transmission within their borders since last year, according to the World Health Organization, which declared a global health emergency on February 1.
The new research does not prove that Zika causes the brain-deforming syndrome.
A flurry of studies has also established strong links to other rare neurological disorders, including one -- Guillain-Barre syndrome -- in which immune defences turns against the body's nervous system, sometimes causing lasting damage or even death.
A number of factors in French Polynesia -- its small population, universal medical records, an epidemic with a clear beginning and end -- created laboratory-like conditions favourable to research.