Congenital Zika syndrome may develop over time in prenatally exposed infants

  • Vianna RAO & al.
  • J Trop Pediatr
  • 21 Apr 2019

  • International Clinical Digest
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Takeaway

  • Roughly one-quarter of Brazilian children born to mothers who experienced a rash during pregnancy were diagnosed with congenital Zika syndrome (CZS) during the first year of life.

Why this matters

  • Monitor infants whose mothers experience Zika virus (ZIKV) rash during pregnancy beyond birth even if they are asymptomatic.
  • Timely identification of developmental, cognitive, neurologic, motor abnormalities may facilitate interventions to slow disability.

Key results

  • 108 children: 40% (43) to ZIKV RT-qPCR-positive mother, 24% (26) RT-qPCR-negative, 36% (39) to mothers with suspected untested ZIKV.
  • Maternal rash reported during first (29%, 31), second (45%, 49), third (20%, 22) trimesters and before pregnancy (5.5%, 6).
  • 24% (26) children diagnosed with CZS, 46% (12) at birth, 54% (14) during follow-up to 10 months.
  • 69% (18) CZS children had microcephaly, 15% (6) diagnosed at birth, 6 postbirth; 100% had developmental delays, motor abnormalities.

Study design

  • Longitudinal, observational study assessing developmental progress of children from birth to 18 months whose mothers developed ZIKV rash during ≤3 months pregestation.
  • Funding: Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior.

Limitations

  • Adherence challenges.
  • In utero exposure to ZIKV, other flaviviruses unmeasured.
  • Observational bias.
  • Selection bias, nongeneralizable.

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