Would <i>Zika virus</i> Infection in Pregnancy Be a Sentence of Poor Neurological Prognosis for Exposed Children? Neurodevelopmental Outcomes in a Cohort from Brazilian Amazon
Marília Rosa Abtibol-Bernardino,
Lucíola de Fátima Albuquerque de Almeida Peixoto,
Marcia da Costa Castilho,
Camila Helena Aguiar Bôtto-Menezes,
Silvana Gomes Benzecry,
Rodrigo Haruo Otani,
Gabriela Ribeiro Ivo Rodrigues,
Beatriz Caroline Soares Chaves,
Geruza Alfaia de Oliveira,
Cristina de Souza Rodrigues,
Flor Ernestina Martinez-Espinosa,
Maria das Graças Costa Alecrim
Affiliations
Marília Rosa Abtibol-Bernardino
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Lucíola de Fátima Albuquerque de Almeida Peixoto
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Marcia da Costa Castilho
Department of Virology, Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Camila Helena Aguiar Bôtto-Menezes
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Silvana Gomes Benzecry
Department of Medicine, School of Health Sciences, State University of Amazonas (UEA), Manaus 69065-001, Brazil
Rodrigo Haruo Otani
Department of Medicine, School of Health Sciences, State University of Amazonas (UEA), Manaus 69065-001, Brazil
Gabriela Ribeiro Ivo Rodrigues
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Beatriz Caroline Soares Chaves
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Geruza Alfaia de Oliveira
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Cristina de Souza Rodrigues
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Flor Ernestina Martinez-Espinosa
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Maria das Graças Costa Alecrim
Postgraduate Program in Tropical Medicine (PPGMT), State University of Amazonas (UEA) in Partnership with the Tropical Medicine Foundation Dr Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil
Infections with Flavivirus in pregnant women are not associated with vertical transmission. However, in 2015, severe cases of congenital infection were reported during the Zika virus outbreak in Brazil. More subtle infections in children born to mothers with ZIKV still remain uncertain and the spectrum of this new congenital syndrome is still under construction. This study describes outcomes regarding neurodevelopment and neurological examination in the first years of life, of a cohort of 77 children born to pregnant women with ZIKV infection in Manaus, Brazil, from 2017 to 2020. In the group of normocephalic children (92.2%), most showed satisfactory performance in neuropsychomotor development, with a delay in 29.6% and changes in neurological examination in 27.1%, with two children showing muscle-strength deficits. All microcephalic children (5.2%) evolved with severe neuropsychomotor-development delay, spastic tetraparesis, and alterations in the imaging exam. In this cohort, 10.5% of the children had macrocephaly at birth, but only 2.6% remained in this classification. Although microcephaly has been considered as the main marker of congenital-Zika-virus syndrome in previous studies, its absence does not exclude the possibility of the syndrome. This highlights the importance of clinical follow-up, regardless of the classification of head circumference at birth.