Heterogeneous development of children with Congenital Zika Syndrome-associated microcephaly

Author(s):Show less -

Aguilar Ticona, Juan P. ^{[1, 2]} ; Nery, Nivison ^{[1, 2]} ; Doss-Gollin, Simon ^[3] ; Gambrah, Claudia ^[4] ; Lessa, Millani ^[1] ; Rastely-Junior, Valmir ^[5] ; Matos, Adriana ^[6] ; Freitas, Bruno de Paula ^{[6, 7]} ; Borja, Ana ^[8] ; Wunder, Elsio A. ^{[4, 2]} ; Ballalai, Verena ^[6] ; Vieira, Carina ^[6] ; Cruz, Jaqueline S. ^[2] ; de Oliveira, Daiana ^[2] ; Araujo, Danielle Bastos ^[9] ; Oliveira, Danielle B. ^[9] ; Nascimento Fabris Maeda, Denicar Lina ^[10] ; Mendes, Erica A. ^[9] ; Soares, Camila Pereira ^[9] ; Durigon, Edison L. ^[9] ; de Souza Ferreira, Luis Carlos ^[10] ; Belfort, Rubens ^[7] ; Almeida, Antonio R. P. ^[6] ; Oliveira-Filho, Jamary ^{[5, 11]} ; Reis, Mitermayer G. ^{[4, 5, 2]} ; Ko, I, Albert ; Costa, Federico ^{[1, 12, 13]}

Affiliation:Show less -

^[1] Univ Fed Bahia, Inst Saude Colet, Salvador, BA - Brazil

^[2] Minist Saude, Inst Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, BA - Brazil

^[3] Boston Childrens Hosp, Div Infect Dis, Precis Vaccines Program, Boston, MA - USA

^[4] Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT - USA

^[5] Univ Fed Bahia, Fac Med Bahia, Salvador, BA - Brazil

^[6] Hosp Geral Roberto Santos HGRS, Salvador, BA - Brazil

^[7] Univ Fed Sao Paulo, Fac Med, Sao Paulo, SP - Brazil

^[8] Univ Fed Bahia, Inst Ciencias Saude, Dept Fonoaudiol, Salvador, BA - Brazil

^[9] Univ Sao Paulo, Inst Ciencias Biomed, Dept Microbiol, Sao Paulo - Brazil

^[10] Univ Sao Paulo, Inst Ciencias Biomed, Dept Microbiol, Lab Desenvolvimento Vacinas, Sao Paulo - Brazil

^[11] Univ Fed Bahia, Programa Posgrad Ciencias Saude PPgCS, Salvador, BA - Brazil

^[12] Ko, Albert, I, Minist Saude, Inst Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, BA - Brazil

^[13] Ko, Albert, I, Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT - USA

• Document type: Journal article
• Source: PLoS One; v. 16, n. 9 SEP 15 2021.
• Web of Science Citations: 0

Abstract

Objective To describe the neurological and neurodevelopmental outcomes of children with Congenital Zika Syndrome (CZS) associated microcephaly beyond 2 years of age. Method 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. Results 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 (beta = 0.29; CI 95% = 0.02-0.57) and motor raw scores (beta = 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 (beta = 1.27; CI 95% = 0.01-2.53) and motor raw scores (beta = 2.03; CI 95% = 0.25-3.81). Conclusion 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. (AU)

• FAPESP's process: 16/20045-7 - Antigen discovery and development of serological diagnostic methods and vaccine approaches against the Zika Virus (ZIKV)
• Grantee: Luis Carlos de Souza Ferreira
• Support Opportunities: Research Projects - Thematic Grants