Autor | Cranston, Jessica S. | |
Autor | Tiene, Sophia Finn | |
Autor | Nielsen-Saines, Karin | |
Autor | Vasconcelos, Zilton Farias Meira de | |
Autor | Pone, Marcos V. | |
Autor | Pone, Sheila Moura | |
Autor | Zin, Andrea | |
Autor | Salles, Tania Regina Dias Saad | |
Autor | Pereira, Jose Paulo | |
Autor | Orofino, Dulce | |
Autor | Brasil, Patricia | |
Autor | Kerin, Tara | |
Autor | Adachi, Kristina | |
Autor | Soares, Fernanda Mendes | |
Autor | Abranches, Andrea Dunshee de | |
Autor | Costa, Ana Carolina C. | |
Autor | Lopes Moreira, Maria Elisabeth | |
Data de acesso | 2020-08-31T23:40:40Z | |
Data de disponibilização | 2020-08-31T23:40:40Z | |
Data do publicação | 2020 | |
Citação | CRANSTON, Jessica S. et al. Association Between Antenatal Exposure to Zika Virus and Anatomical and Neurodevelopmental Abnormalities in Children. JAMA Network Open, v. 3, n. 7, p. 1-13, 2020. | pt_BR |
ISSN | 2574-3805 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/43099 | |
Idioma | eng | pt_BR |
Editor | American Medical Association | pt_BR |
Direito Autoral | restricted access | pt_BR |
Título | Association Between Antenatal Exposure to Zika Virus and Anatomical and Neurodevelopmental Abnormalities in Children | pt_BR |
Tipo do documento | Article | pt_BR |
DOI | 10.1001/jamanetworkopen.2020.9303 | |
Resumo em Inglês | Importance: Zika virus (ZIKV) is a mosquito-borne flavivirus recognized as teratogenic since the 2015 to 2016 epidemic. Antenatal ZIKV exposure causes brain anomalies, yet the full spectrum has not been delineated.
Objective: To characterize the clinical features of ZIKV infection at a pediatric referral center in Rio de Janeiro, Brazil, among children with antenatal ZIKV exposure.Main outcomes and measures: Characterization of clinical features with anthropometric, neurologic, cardiologic, ophthalmologic, audiometric, and neuroimaging evaluations in infancy and neurodevelopmental assessments (Bayley Scales of Infant and Toddler Development, Third Edition) from 6 to 42 months of age, stratified by head circumference at birth (head circumference within the reference range, or normocephaly [NC] vs microcephaly [MC]).
Results: Antenatal exposure to ZIKV was confirmed for 219 of 296 children (74.0%) referred to Instituto Fernandes Figueira with suspected ZIKV infection through positive maternal or neonatal polymerase chain reaction analysis or IgM serology results. Of these children, 110 (50.2%) were boys, ages ranged from 0 to 4 years, and 53 (24.2%) had congenital microcephaly. The anomalies observed in ZIKV-exposed children with MC or NC were failure to thrive (MC: 38 of 53 [71.7%]; NC: 73 of 143 [51.0%]), cardiac malformations (MC: 19 of 46 [41.3%]; NC: 20 of 100 [20.0%]), excess nuchal skin (MC: 16 of 22 [72.7%]; NC: 35 of 93 [37.6%]), auditory abnormalities (MC: 13 of 50 [26.0%]; NC: 14 of 141 [9.9%]), and eye abnormalities (MC: 42 of 53 [79.2%]; NC: 28 of 158 [17.7%]). Although they experienced fewer neurologic abnormalities than children born with MC, those with NC also had frequent neurologic abnormalities (109 of 160 [68.1%]), including hyperreflexia (36 of 136 [26.5%]), abnormal tone (53 of 137 [38.7%]), congenital neuromotor signs (39 of 93 [41.9%]), feeding difficulties (15 of 143 [10.5%]), and abnormal brain imaging results (44 of 150 [29.3%]). Among 112 children with NC with Bayley-III evaluations, 72 (64.3%) had average or above-average scores; 30 (26.8%) scored 1 SD below average in at least 1 domain; and 10 (8.9%) scored 2 SD below average in at least 1 domain. Among 112 children with NC, a smaller head circumference at birth was significantly associated with subsequent below-average cognitive scores (U = 499.5; z = -2.833; P = .004) and language scores (U = 235.5; z = -2.491; P = .01).
Conclusions and relevance: Children without MC who were exposed to ZIKV in utero had a high frequency of anatomical and neurodevelopmental abnormalities. The head circumference at birth for children with NC was associated with neurocognitive development. Recognition of the wide spectrum of clinical phenotypes is critical to ensure early referral to rehabilitative interventions. | pt_BR |
Afiliação | David Geffen School of Medicine at University of California. Department of Pediatrics. Division of Infectious Diseases. Los Angeles, USA. | pt_BR |
Afiliação | David Geffen School of Medicine at University of California. Department of Pediatrics. Division of Infectious Diseases. Los Angeles, USA. | pt_BR |
Afiliação | David Geffen School of Medicine at University of California. Department of Pediatrics. Division of Infectious Diseases. Los Angeles, USA. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | David Geffen School of Medicine at University of California. Department of Pediatrics. Division of Infectious Diseases. Los Angeles, USA. | pt_BR |
Afiliação | David Geffen School of Medicine at University of California. Department of Pediatrics. Division of Infectious Diseases. Los Angeles, USA. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, Criança e Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA. Brasil. | pt_BR |
Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Palavras-chave em inglês | Zika Virus | pt_BR |
Palavras-chave em inglês | Pregnancy | pt_BR |
Palavras-chave em inglês | Antenatal Zika virus exposure | pt_BR |
Palavras-chave em inglês | Neurodevelopmental | pt_BR |
Data de embargo | 2040-01-01 | |