Clinical follow-up of children with in utero Zika virus exposure in the Metropolitan Region of Belém, Pará State, Brazil

Abstract

INTRODUCTION:

The emergence of the Zika virus (ZIKV), which severely affected Northeastern Brazil, revealed the occurrence of congenital malformations during pregnancy. Currently, changes have been recorded from physical abnormalities, such as microcephaly, arthrogryposis, and brain abnormalities detected by neuroimaging tests, to behavioral changes as irritability and excitability.

OBJECTIVE:

From this perspective, a multidisciplinary approach was conducted by clinical follow up and lab and imaging tests, with emphasis on investigating the neurological and psychomotor development, vision and hearing in order to get information on maternal and fetal infection.

MATERIALS AND METHODS:

For that purpose, 92 children born to women infected by ZIKV during pregnancy were followed up from August 2017 to July 2018.

RESULTS:

Among the patients investigated, 55 (59.8%) children were male; 46 (50.0%) mothers were infected in the second trimester of pregnancy; two (2.2%) children had microcephaly at birth and one (1.1%) presented signs and symptoms associated with postnatal microcephaly. In addition, during clinical follow-up, behavioral changes that could affect child neurodevelopment were found, such as extreme irritability, with significant incidence (p < 0.0001), followed by aggressiveness and hyperexcitability, despite normal imaging tests.

CONCLUSION:

According to these results, must be enhanced the need for multi-professional follow up of children with in utero ZIKV exposure in order to identify early and late changes associated with ZIKV and to conduct psychomotor activities that can reduce the sequelae in child neurodevelopment.