Prevalence and diagnostic accuracy of microcephaly in a pediatric cohort in Brazil: a retrospective cross-sectional study

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Antunes Pascalicchio Bertozzi, Ana Paula ^[1] ; Gazeta, Rosa Estela ^[1] ; Gillo Fajardo, Thamirys Cosmo ^[2] ; Moron, Antonio Fernandes ^[3] ; Soriano-Arandes, Antoni ^[4] ; Alarcon, Ana ^[5] ; Garcia-Alix, Alfredo ^[6] ; da Silva, Alify Bertoldo ^[1] ; Florence Filho, Nemesio ^[1] ; Pereira Sarmento, Stephanno Gomes ^[7] ; Witkin, Steven S. ^{[8, 9, 3]} ; Duarte Passos, Saulo ^[1]

Afiliação do(s) autor(es)

^[1] Fac Med Jundiai, Dept Pediat, Jundiai, SP - Brazil

^[2] Fac Med Jundiai, Lab Infectol Pediat, Jundiai, SP - Brazil

^[3] Univ Sao Paulo, Inst Med Trop, Sao Paulo, SP - Brazil

^[4] Hosp Univ Vall dHebron, Paediat Infect Dis & Immunodeficiencies Unit, Unit Int Hlth TB Vall Hebron Drassanes, Barcelona - Spain

^[5] Hosp Univ St Joan de Deu, Dept Neonatol, Inst Recerca St Joan de Deu, Esplugas de Llobregat - Spain

^[6] Univ Barcelona, Fdn NeNe, Inst Recerca St Joan Deu, Esplugas de Llobregat - Spain

^[7] Fac Med Jundiai, Dept Ginecol & Obstet, Jundiai, SP - Brazil

^[8] Fac Med Jundiai, Jundiai, SP - Brazil

^[9] Weill Cornell Med, Dept Obstet & Gynecol, New York, NY - USA

• Tipo de documento: Artigo Científico
• Fonte: Jornal de Pediatria; v. 97, n. 4, p. 433-439, JUL-AUG 2021.
• Citações Web of Science: 0

Resumo

Abstract Objective We sought to describe the prevalence of microcephaly and to compare the different cutoff points established by the Brazilian Ministry of Health at various times during a Zika virus epidemic. As a secondary aim, we investigated the possible etiology of the microcephaly. Method This retrospective study utilized newborn participants in the Zika Cohort Study Jundiaí. Newborns from the Zika Cohort Study Jundiaí with an accurate gestational age determination and complete anthropometric data were analyzed, and microcephaly was diagnosed according to the INTERGROWTH-21st curve. At delivery, fluids were tested for specific antibodies and for viruses. Brain images were evaluated for microcephaly. Receiver Operating Characteristic curves were plotted to define the accuracy of different cutoff points for microcephaly diagnosis. Results Of 462 eligible newborns, 19 (4.1%) were positive for microcephaly. Cutoff points corresponding to the curves of the World Health Organization yielded the best sensitivity and specificity. Three of the microcephaly cases (15.8%) were positive for Zika virus infections; nine (47.4%) had intrauterine growth restriction; one had intrauterine growth restriction and was exposed to Zika virus; three had a genetic syndrome (15.8%); and three had causes that had not been determined (15.8%). Conclusions Microcephaly prevalence was 4.1% in this study. Cutoff values determined by the World Health Organization had the highest sensitivity and specificity in relation to the standard IG curve. The main reason for microcephaly was intrauterine growth restriction. All possible causes of microcephaly must be investigated to allow the best development of an affected baby. (AU)

• Processo FAPESP: 16/08578-0 - Infecção vertical pelo vírus Zika e suas repercussões na área materno-infantil
• Beneficiário: Saulo Duarte Passos
• Modalidade de apoio: Auxílio à Pesquisa - Temático