Produção Nacional
Revisado por pares
Neurodevelopmental delays arising from in utero exposure to Zika virus in Salvador, Brazil
2018; Elsevier BV; Volume: 73; Linguagem: Inglês
10.1016/j.ijid.2018.04.3533
ISSN1878-3511
AutoresJoão de Pina Cabral, Adriana Virgínia Barros Faiçal, Breno Lima de Almeida, João Vitor Oliveira, Emília Katiane Embiruçu, Nuno Ferreira, Laila Araújo de Oliveira dos Reis, Cristina Salles, Bernardo Pereira Cabral, Breno dos Anjos Costa, Marcos Vinícius Lima de Oliveira Francisco, Carine Ribeiro dos Santos, Luíz Carlos Júnior Alcântara, Angelina Xavier Acosta, Isadora Cristina de Siqueira,
Tópico(s)Autism Spectrum Disorder Research
ResumoBackground: Since 2015, Brazil has experienced an unprecedented Zika virus outbreak. A devastating consequence of this viral infection is congenital Zika infection (CZI), which is transmitted from pregnant women to newborns. Most descriptions and publications regarding CZI focus on the clinical presentation of newborns and infants with microcephaly. Scarce information is available concerning children without microcephaly born from infected mothers. During 2016, in the city of Salvador (Bahia, Brazil), a cross-sectional study enrolled 103 pregnant women who reported an exanthematous disease during pregnancy. Of these, 69 (67%) presented anti-Zika antibodies at the time of delivery. A total of 7 (6.8%) newborns were diagnosed with microcephaly, while 96 (93.2%) were classified as newborns without microcephaly. Methods & Materials: In June 2017, we began a prospective follow-up of these infants without microcephaly exposed to Zika Virus in utero by evaluating neurodevelopment delays, performing neurological examinations and applying the Bayley Scales of Infant Development III (BSID-III), Mental Development Index (MDI) and Bayley-III cognitive and language scales. Auditory evaluations were performed by Otoacustic emissions (OAE) and Brainstem Auditory Evoked Potential (BAEP). Results: To date we have evaluated 18 infants, mean age 1.7 years. Of these, 55.6% are male and 61% were delivered by C-section. Anti-Zika IgG serology was positive in 75% and three (16.6%) presented positivity for Zika by PCR on urine samples within 24 h of birth. Based on head circumference (HC) at time of birth, all were classified as normal by the Intergrowth scale and currently fall within normal HC percentiles. Cognitive delay was identified in five (33%) infants, language delay in four (26.6%) and motor delay in two (13.3%). Conclusion: Our preliminary results indicate that in utero exposure to Zika virus could be associated with neurodevelopmental delay, even in children born without microcephaly at birth. Currently, only microcephalic infants are referred to specialized care, while normocephalic children are maintained in primary health care. We believe that all newborns exposed to Zika in utero should be referred to specialized centers for the early detection of neurodevelopmental delays and timely intervention.
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