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ZIKACTION PAEDIATRIC REGISTRY: MATERNAL CHARACTERISTICS AND CLINICAL, RADIOLOGICAL, AND FOLLOW-UP FEATURES OF CHILDREN BORN WITH CONGENITAL ZIKA INFECTION IN BRAZIL
Abstract
Background
In 2015, Brazil experienced an unexpected increase in newborns with microcephaly. Subsequently, the association between microcephaly and Congenital Zika Infection (CZI) was confirmed.
Aims
This study, part of the ZIKAction Paediatric Registry, intends to describe clinical, radiological, neurodevelopmental, and laboratory features and follow-up of children with CZI in Bahia, Brazil.
Methods
This observational study had following inclusion criteria: intrauterine exposure to ZIKV, laboratory-confirmed CZI, or meeting the definition of suspected CZI, based on clinical and radiological features.
Results
Of 129 participants, 57% were female. Most mothers (75%) had symptoms suggestive of Zika infection during pregnancy. Median gestational age at delivery was 38 weeks, with 19% delivered preterm. Median birth length and weight were 46cm and 2690g, respectively. Most infants (118, 91.5%) had microcephaly (median head circumference Z-score -3.51, IQR -4.69,-2.73), and 17 (13.2%) have arthrogryposis. During follow-up, 96% and 92% of children had hearing and ophthalmological assessments, with 21% and 57% having abnormalities respectively. Brain image was abnormal in all cases, with ventriculomegaly (70.1%), cerebral parenchyma calcifications (62.1%), and cortical atrophy (48.6%) were main findings. Median age at last follow-up was 5 years; to date, 54 (42%) participants needed hospitalization, 44 (35%) needed care in the emergency department, and two (1.5%) died.
Conclusions
CZI is an emerging disease shown to have a varied spectrum. Registry children were biased towards those with more severe disease, with several abnormalities and complications observed. Continued long-term follow-up is essential to understand the prognosis and clinical spectrum as these children reach school-age.