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. 2019 Dec 1;65(6):592-602.
doi: 10.1093/tropej/fmz019.

Children Born to Mothers with Rash During Zika Virus Epidemic in Brazil: First 18 Months of Life

Renata Artimos de Oliveira Vianna  1 , Kathryn Lynn Lovero  2 , Solange Artimos de Oliveira  1 , Alexandre Ribeiro Fernandes  1 , Teresa Cristina Sarmet Dos Santos  1 , Luiz Cláudio Santos de Souza Lima  1 , Fabiana Rabe Carvalho  1 , Maria Dolores Salgado Quintans  1 , Arnaldo Costa Bueno  1 , Ana Flávia Malheiros Torbey  1 , Aurea Lucia Alves Azevedo Grippa de Souza  1 , Armanda de Oliveira Pache de Farias  1 , Luiz Antonio Bastos Camacho  3 , Lee Woodland Riley  4 , Claudete Aparecida Araújo Cardoso  1
Affiliations

Children Born to Mothers with Rash During Zika Virus Epidemic in Brazil: First 18 Months of Life

Renata Artimos de Oliveira Vianna et al. J Trop Pediatr. .

Abstract

Objective: To better understand the clinical spectrum and course of congenital Zika syndrome (CZS) during the first 18 months of life of children whose mothers had rash during pregnancy.

Methods: This longitudinal observational study evaluated the clinical progress from birth until 18 months of life of children of mothers who developed rash during or up to 3 months before gestation. Maternal rash occurred from November 2015 to May 2017. The study subjects were divided into three groups: children whose mothers tested positive by RT-qPCR for Zika virus (ZIKV) (Group 1), children whose mothers tested negative by RT-qPCR for ZIKV (Group 2), and children whose mothers did not undergo any testing for ZIKV (Group 3) but tested negative for other congenital infections.

Results: Between April 2016 and July 2018, we studied 108 children: 43 in Group 1, 26 in Group 2 and 39 in Group 3. The majority of children were admitted into the study within 6 months of life. CZS was diagnosed in 26 children, equally distributed in Groups 1 and 3. Of 18 children with microcephaly, 6 were in Group 1 (1 postnatal) and 12 were in Group 3 (5 postnatal). Maternal rash frequency was 10 times higher during the first trimester than in the other trimesters (OR: 10.35; CI 95%: 3.52-30.41). CZS was diagnosed during the follow-up period in 14 (54%) cases. Developmental delays and motor abnormalities occurred in all children and persisted up to 18 months. Epilepsy occurred in 18 (69%) of the cases.

Conclusions: Infants born of mothers exposed to ZIKV during pregnancy showed progression of developmental, motor and neurologic abnormalities even if they were born asymptomatic. Continued postnatal monitoring of such newborns is necessary to preclude disability-associated complications.

Keywords: Congenital Zika syndrome; RT-PCR; Zika virus; microcephaly.

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Figures

<sc>Fig</sc>. 1.
Fig. 1.
Flowchart of study population. ZIKV, Zika virus; RT-qPCR, real-time reverse transcription polymerase chain reaction.
<sc>Fig</sc>. 2.
Fig. 2.
Frequency of maternal rash by year and month, and CZS patients’ month of birth. CZS, congenital Zika syndrome.
See this image and copyright information in PMC

References

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