Journal Article

Heterogeneous development of children with Congenital Zika Syndrome-associated microcephaly

Oliveira, Danielle B., Doss-Gollin, Simon, de Oliveira, Daiana, Lessa, Millani, Nascimento Fabris Maeda, Denicar Lina, Gambrah, Claudia, Mendes, Erica A., Nery, Nivison, Reis, Mitermayer G., Borja, Ana, Costa, Federico, Rastely-Júnior, Valmir, Belfort, Rubens, Ballalai, Verena, de Souza Ferreira, Luis Carlos, Ko, Albert I., Vieira, Carina, Cruz, Jaqueline S., Pereira Soares, Camila, Araujo, Danielle Bastos, Wunder, Elsio A., P. Almeida, Antonio R., de Paula Freitas, Bruno, Oliveira-Filho, Jamary, Matos, Adriana, Durigon, Edison L., Aguilar Ticona, Juan P.

2021

Overview

To describe the neurological and neurodevelopmental outcomes of children with Congenital Zika Syndrome (CZS) associated microcephaly beyond 2 years of age. We followed children with CZS-associated microcephaly in an outpatient clinic in Salvador, Brazil. Neurological and neurodevelopmental assessments were performed using the Hammersmith Infant Neurological Examination (HINE) and Bayley Scales of Infant and Toddler Neurodevelopment (Bayley-III) respectively. Of the 42 children included, 19 were male (45.2%); median (interquartile range) age at neurological evaluation was 28 (25-32) months, and 36 (85.7%) had severe microcephaly. HINE and Bayley-III results were completed for 35/42 (83.3%) and 33/42 (78.5%) children respectively. Bayley-III identified a severe developmental delay in 32/33 (97.0%) children while 1/33 (3.0%) had only a mild delay. In the multivariable analysis, we found that Bayley-III and HINE scores were correlated. Better HINE scores were associated with higher Bayley-III cognitive raw scores (β = 0.29; CI 95% = 0.02-0.57) and motor raw scores (β = 0.43; CI 95% = 0.04-0.82) after adjusting for head circumference, prematurity, and age at neurodevelopmental evaluation. Furthermore, we found that greater head circumference at follow up was associated with higher cognitive (β = 1.27; CI 95% = 0.01-2.53) and motor raw scores (β = 2.03; CI 95% = 0.25-3.81). Children with CZS-associated microcephaly demonstrate severe neurodevelopmental delays and slower growth rates than their peers over time. Still, they have remarkably heterogeneous neurodevelopmental profiles according to neurological exam scores which correlate with their long-term outcomes. We found that HINE scores effectively captured the heterogeneity of neurological capabilities among these children and could be predictive of cognitive and motor development progress.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Age / Biology and Life Sciences / Brazil - epidemiology / Cephalometry / Child, Preschool / Children / Children & youth / Circumferences / Cognitive ability / Congenital diseases / Developmental Disabilities - diagnosis / Developmental Disabilities - physiopathology / Developmental Disabilities - virology / Epidemiology / Evaluation / Female / Growth rate / Heterogeneity / Hospitals / Humans / Infant / Infant, Newborn / Infants / Male / Medicine and Health Sciences / Microcephaly / Microcephaly - diagnosis / Microcephaly - epidemiology / Microcephaly - etiology / Microcephaly - virology / Microencephaly / Neurodevelopment / Neurologic Examination / Outpatient care facilities / Pediatrics / People and Places / Pregnancy / Pregnancy Complications, Infectious - diagnosis / Pregnancy Complications, Infectious - epidemiology / Pregnancy Complications, Infectious - physiopathology / Pregnancy Complications, Infectious - virology / Public health / Research and Analysis Methods / Risk factors / Vector-borne diseases / Zika virus / Zika Virus - pathogenicity / Zika Virus Infection - complications / Zika Virus Infection - diagnosis / Zika Virus Infection - virology