Seguimento de crianças expostas intraútero ao vírus Zika na Região Metropolitana de Belém, Pará, Brasil

C. S. Oliveira, H. J. Matos, Luna Thais Sousa Gomes, Emilene Monteiro Furtado Serra, Marcella Cruz Fraiha, Déborah Silva Nunes
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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.
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随访belem, para,巴西大都市地区宫内暴露于寨卡病毒的儿童
寨卡病毒(ZIKV)的出现严重影响了巴西东北部地区,揭示了怀孕期间先天性畸形的发生。目前,记录的变化从身体异常,如小头畸形、关节挛缩和神经影像学检查发现的脑异常,到行为改变,如易怒和兴奋性。目的:从这一角度出发,通过临床随访、实验室和影像学检查等多学科方法,重点研究神经和精神运动发育、视力和听力,以获取母胎感染信息。材料和方法:为此,从2017年8月至2018年7月,对92名感染寨卡病毒的孕妇所生的儿童进行了随访。结果:调查患者中,男性患儿55例(59.8%);46名(50.0%)母亲在妊娠中期感染;2名(2.2%)儿童在出生时患有小头畸形,1名(1.1%)儿童出现与出生后小头畸形相关的体征和症状。此外,在临床随访中,发现可能影响儿童神经发育的行为改变,如极度易怒,发生率显著(p < 0.0001),其次是攻击性和高兴奋性,尽管影像学检查正常。结论:应加强对宫内感染寨卡病毒儿童的多专业随访,以发现寨卡病毒的早期和晚期相关变化,并开展精神运动活动,减少儿童神经发育的后遗症。
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