Three-Year Clinical Follow-Up of Children Intrauterine Exposed to Zika Virus
Abstract
:1. Introduction
2. Materials and Methods
2.1. Laboratory Diagnosis
2.2. Statistical Analysis
2.3. Ethical Procedures
3. Results
Cohort General Characteristics
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Sociodemographic Characteristics | Pregnant Women (n = 764) |
---|---|
Age (years) (n = 763) | |
Mean (±standard deviation) | 27.4 (±7.3) |
Median (IIQ 25–75%) | 27 (21–33) |
Minimum–maximum | 13–46 |
Age (years) | n (%) |
13 to 19 | 123 (16.1) |
20 to 34 | 497 (65.1) |
35 to 46 | 143 (18.7) |
Not informed | 1 (0.1) |
Ethnicity | |
White | 398 (52.1) |
Brown | 267 (34.9) |
Black | 79 (10.3) |
Indigenous | 2 (0.3) |
Not informed | 18 (2.4) |
Paid work | |
Yes | 346 (45.3) |
No | 401 (52.5) |
Not informed | 17 (2.2) |
Risk factors | |
Gestational or type I diabetes mellitus | 199 (26) |
Chronic or gestational arterial hypertension | 78 (10.2) |
Early Pregnancy | 71 (9.3) |
Microcephaly (suspected or confirmed) | 50 (6.5) |
Twinning | 25 (3.3) |
Suggestive symptoms Zika1 | 11 (1.4) |
Others | 274 (35.8) |
No information | 14 (2.6) |
Changes in obstetric ultrasound compatible with Zika | |
Yes | 41 (5.4) |
No | 713 (93.3) |
Not informed | 10 (1.3) |
Type of delivery | |
Vaginal | 358 (46.9) |
Cesarean | 371 (48.6) |
Forceps | 18 (2.4) |
No information | 16 (2.1) |
Zika symptoms | |
Yes | 40 (5.2) |
No | 723 (94.7) |
Not informed | 1 (0.1) |
Zika Virus PCR | |
Detectable | 57 (7.5) |
Not detectable | 691 (90.4) |
No information | 16 (2.1) |
Dengue (IgM) | |
Detectable | 31 (4.0) |
Not detectable | 624 (8.,7) |
No information | 109 (14.3) |
Chikungunya (IgM) | |
Detectable | 4 (0.5) |
Not detectable | 731 (95.7) |
No information | 29 (3.8) |
Viral co-infection | |
Zika and dengue | 4 (0.5) |
Clinical Characteristics | Total | Children with Zika or Exposed (Mothers Confirmed with Zika) | Control (Non-Reactive) | p-Value | OR (95% CI) |
---|---|---|---|---|---|
Gestational age (weeks) [n (%)] | n = 797 | n = 83 | n = 672 | ||
≤31 | 21 (2.6) | 1 (1.2) | 20 (3.0) | 0.496 1 | 0.38 (0.05–2.88) |
32 to 36 | 114 (14.3) | 10 (12.1) | 104 (15.5) | 0.376 2 | 0.73 (0.37–1.47) |
≥37 | 620 (77.8) | 72 (86.7) | 548 (81.5) | - | 1 |
Weight (grams) | n = 777 | n = 82 | n = 695 | ||
Mean (±standard deviation) | 2970.9 (±636.3) | 3147.4 (±549.3) | 2950.1 (±643.0) | - | - |
Median (IIQ 25–75%) | 3015 (2618–3398) | 3222 (2790–3526) | 2980 (2595–3375) | 0.006 3 | - |
Minimum–maximum | 560–4525 | 1270–4285 | 560–4525 | - | - |
Low weight at birth | n = 83 | n = 672 | |||
Yes (<2.500 g) | 151 (19.4) | 7 (8.5) | 144 (20.7) | 0.008 2 | 0.35 (0.16–0.79) |
No (≥2.500 g) | 626 (80.6) | 75 (91.5) | 551 (79.3) | - | 1 |
Length (cm) | n = 82 | n = 692 | |||
Mean (± standard deviation) | 47.4 (±3.3) | 48.3 (±2.7) | 47.3 (±3.3) | - | - |
Median (IIQ 25–75%) | 48 (46–50) | 48 (47–50) | 48 (46–50) | 0.004 3 | - |
Minimum–maximum | 28.5–54.5 | 38.0–53.0 | 28.5–54.5 | - | - |
APGAR 5 min | n = 695 | n = 78 | n = 617 | ||
Mean (±standard deviation) | 9.3 (±0.8) | 9.3 (±0.8) | 9.3 (±0.8) | 0.692 3 | - |
Median (IIQ 25–75%) | 9 (9–10) | 9 (9–10) | 9 (9–10) | - | - |
Minimum–maximum | 4–10 | 5–10 | 4–10 | - | - |
APGAR 5 min | n = 695 | n = 83 | n = 672 | ||
1 a 6 | 8 (1.2) | 1 (1.3) | 7 (1.1) | 1.000 1 | 1.13 (0.14–9.32) |
7 a 10 (normal) | 687 (98.8) | 77 (98.7) | 610 (98.9) | - | 1 |
Head circumference (cm) | n = 768 | n = 82 | n = 686 | ||
Mean (±standard deviation) | 33.6 (±2.3) | 34.1 (±1.9) | 33.6 (±2.3) | - | - |
Median (IIQ 25–75%) | 34 (33–35) | 34 (33–35) | 34 (32–35) | 0.163 3 | - |
Minimum–maximum | 21–38.5 | 27–38 | 21–38.5 | - | - |
Microcephaly [n (%)] | n = 797 | n = 83 | n = 694 | ||
Yes | 48 (6.0) | 3 (3.6) | 45 (6.5) | 0.295 2 | 0.53 (0.16–1.76) |
No | 730 (91.6) | 81 (96.4) | 649 (93.5) | 1 |
Clinical Characteristics | Total | Children with Zika or Exposed (Mothers Confirmed with Zika) | Control (Non-Reactive) | p-Value | OR (95% CI) |
---|---|---|---|---|---|
Pregnant women with diabetes mellitus 1 | |||||
Weight (grams) | n = 206 | n = 28 | n = 178 | ||
Mean (±standard deviation) | 3206.1 (±532.1) | 3280.0 (±403.7) | 3194.5 (±549.6) | - | - |
Median (IIQ 25–75%) | 3250 (2890–3555) | 3250 (2950–3599) | 3250 (2960–3598) | 0.582 2 | - |
Minimum–maximum | 720–4330 | 2560–4090 | 720–4330 | - | - |
Low weight at birth | |||||
Yes (<2.500 g) | 14 (6.8) | - | 14 (100.0) | 0.224 3 | 0.20 (0.11–3.43) |
No (≥2.500 g) | 192 (93.2) | 28 (14.6) | 164 (85.4) | - | 1 |
Pregnant women without diabetes mellitus | |||||
Weight (grams) | n = 553 | n = 53 | n = 500 | ||
Mean (±standard deviation) | 2877.9 (±642.7) | 3074.1 (±608.2) | 2857.1 (±654.4) | - | - |
Median (IIQ 25–75%) | 2930 (2515–3330) | 3115 (2680–3495) | 2920 (2486–3281) | 0.020 2 | - |
Minimum–maximum | 560–4525 | 1270–4285 | 560–4525 | - | - |
Low weight at birth | |||||
Yes (<2.500 g) | 135 (24.4) | 7 (5.2) | 128 (94.8) | 0.046 4 | 0.44 (0.18–0.97) |
No (≥2.500 g) | 418 (75.6) | 46 (11.0) | 372 (89.0) | - | 1 |
Clinical Characteristics | Total | Children with Zika or Exposed (Mothers Confirmed with Zika) | Control (Non-Reactive) | p-Value | OR (IC95%) |
---|---|---|---|---|---|
Preterm birth 1 | |||||
Weight (grams) | n = 11 | n = 120 | |||
Mean (±standard deviation) | 2293.4 (±712.1) | 2337.3 (±551.4) | 2289.4 (±726.8) | - | - |
Median (IIQ 25–75%) | 2320 (1840–2865) | 2370 (2200–2695) | 2305 (1825–2876) | 0.845 3 | - |
Minimum–maximum | 560–3573 | 1270–3055 | 560–3573 | - | - |
Low weight at birth | |||||
Yes (<2.500 g) | 76 (58.0) | 6 (7.9) | 70 (92.1) | >0.999 4 | 0.86 (0.25–2.97) |
No (≥2.500 g) | 55 (42.0) | 5 (9.1) | 50 (90.9) | - | 1 |
Term birth 2 | |||||
Weight (grams) | n = 615 | n = 70 | n = 545 | ||
Mean (±standard deviation) | 3119.0 (±513.7) | 3269.2 (±434.0) | 3099.7 (±520.2) | - | - |
Median (IIQ 25−75%) | 3120 (2780–3475) | 3272 (2924–3555) | 3090 (2760–3455) | 0.009 3 | - |
Minimum–maximum | 1320–4525 | 2340–4285 | 1320–4525 | - | - |
Low weight at birth | |||||
Yes (<2.500 g) | 69 (11.2) | 1 (1.4) | 68 (98.6) | 0.006 5 | 0.10 (0.01–0.74) |
No (≥2.500 g) | 546 (88.8) | 69 (12.6) | 477 (87.4) | - | 1 |
Variables | Total | Children with Zika or Exposed (Mothers Confirmed with Zika) | Control (Non-Reactive) | p-Value | OR (IC95%) | |
---|---|---|---|---|---|---|
Result of dengue in pregnant women (exposure) | ||||||
Positive | 34 (4.3) | 8 (10.5) | 26 (4.3) | 0.043 1 | 2.62 (1.14–6.03) | |
Negative | 648 (81.3) | 68 (89.5) | 580 (95.7) | - | 1 | |
No information | 115 (14.4) | - | - | - | - | |
Result of chikungunya in pregnant women (exposure) | ||||||
Positive (IgM) | 4 (0.5) | 1 (1.2) | 3 (0.4) | 0.369 1 | 2.76 (0.28–26.84) | |
Negative | 761 (95.5) | 82 (98.8) | 679 (99.6) | - | 1 | |
No information | 32 (4.0) | - | - | - | - | |
Vision impairment | ||||||
Yes | 8(1) | 1 | 7 (3.0) | 0.353 1 | 0.27 (0.01–4835.00) 2 | |
No | 281 (35.3) | 55 (100.0) | 226 (97.0) | - | 1 | |
No information | 509 (63.8) | - | - | - | - | |
Arthrogryposis | ||||||
Yes | - | - | - | - | - | |
No | 572 (71.8) | 65 (100.0) | 507 (100.0) | - | 1 | |
No information | 225 (28.2) | - | - | - | - | |
Hearing Loss | ||||||
Yes | 8 (1.0) | 3 (4.9) | 4 (1.5) | 0.123 1 | 3.40 (0.74–15.61) | |
No | 312 (39.1) | 58 (95.1) | 263 (98.5) | - | 1 | |
No information | 479 (59.9) | - | - | - | - | |
Abnormalities in post-natal imaging | ||||||
Yes | 17 (2.1) | 5 (11.1) | 12 (13.0) | 0.747 2 | 0.83 (0.28–2.53) | |
No | 120 (15.1) | 40 (88.9) | 80 (87.0) | - | 1 | |
No information | 660 (82.8) | - | - | - | - | |
Abnormalities of neuropsychomotor development | ||||||
Yes | 27 (3.4) | 9 (13.2) | 18 (3.8) | 0.003 1 | 3.85 (1.65–8.96) | |
No | 513 (64.4) | 59 (86.8) | 454 (96.2) | - | 1 | |
No information | 257 (32.2) | - | - | - | - | |
Dysphagia | ||||||
Yes | 15 (1.9) | 6 (10.0) | 9 (2.9) | 0.022 1 | 3.68 (1.26–10.76) | |
No | 352 (44.2) | 54 (90.0) | 298 (97.1) | - | 1 | |
No information | 429 (53.9) | - | - | - | - |
Variables | Univariate Analysis OR (95% CI) | Multivariate Analysis OR (95% CI) |
---|---|---|
Positive dengue result in pregnant women | 2.62 (1.14–6.03) | 4.13 (1.04–16.42) |
Hearing Loss | 3.40 (0.74–15.61) | 1.29 (0.12–13.57) |
Abnormalities of neuropsychomotor development | 3.85 (1.65–8.96) | 10.33 (1.96–54.50) |
Dysphagia | 3.68 (1.26–10.76) | 1.99 (0.38–10.45) |
Low weight at birth | 0.35 (0.16–0.79) | 0.54 (0.15–2.01) |
Microcephaly | 0.46 (0.18–1.17) | 0.28 (0.06–1.22) |
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Gazeta, R.E.; Bertozzi, A.P.A.P.; Dezena, R.d.C.d.A.B.; Silva, A.C.B.; Fajardo, T.C.G.; Catalan, D.T.; Rizzo, M.d.F.V.; Moron, A.F.; Soriano-Arandes, A.; Clemente, N.S.; et al. Three-Year Clinical Follow-Up of Children Intrauterine Exposed to Zika Virus. Viruses 2021, 13, 523. https://doi.org/10.3390/v13030523
Gazeta RE, Bertozzi APAP, Dezena RdCdAB, Silva ACB, Fajardo TCG, Catalan DT, Rizzo MdFV, Moron AF, Soriano-Arandes A, Clemente NS, et al. Three-Year Clinical Follow-Up of Children Intrauterine Exposed to Zika Virus. Viruses. 2021; 13(3):523. https://doi.org/10.3390/v13030523
Chicago/Turabian StyleGazeta, Rosa Estela, Ana Paula Antunes Pascalicchio Bertozzi, Rita de Cássia de Aguirre Bernardes Dezena, Andrea Cristina Botelho Silva, Thamirys Cosmo Gillo Fajardo, Daniel T. Catalan, Maria de Fátima Valente Rizzo, Antonio Fernandes Moron, Antoni Soriano-Arandes, Nuria Sanchez Clemente, and et al. 2021. "Three-Year Clinical Follow-Up of Children Intrauterine Exposed to Zika Virus" Viruses 13, no. 3: 523. https://doi.org/10.3390/v13030523
APA StyleGazeta, R. E., Bertozzi, A. P. A. P., Dezena, R. d. C. d. A. B., Silva, A. C. B., Fajardo, T. C. G., Catalan, D. T., Rizzo, M. d. F. V., Moron, A. F., Soriano-Arandes, A., Clemente, N. S., Quintella, T., Ventura, D. F., Damico, F. M., França, V. d. C. R. d. M., Almeida, J. P. G. d., Zara, A. L. d. S. A., Pires, L. C., Jundiaí, C. Z. v., & Passos, S. D. (2021). Three-Year Clinical Follow-Up of Children Intrauterine Exposed to Zika Virus. Viruses, 13(3), 523. https://doi.org/10.3390/v13030523