临床和流行病学的母婴二联体与小胎儿和怀疑感染寨卡病毒在妊娠期:一项分段研究

Manoel Alfredo Curvelo Sarno, Luciana Carla Belém dos Santos, Priscila Pinheiro Ribeiro Lyra, C. Mendes, P. R. Oliveira, Ana Cecília Travassos Santiago
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引用次数: 0

摘要

导读:许多作者观察到2015年至2016年间巴西小头症发病率增加与寨卡病毒感染(ZIKV)流行爆发之间的关联。世界卫生组织宣布其为国际关注的突发公共卫生事件。母体感染寨卡病毒可通过垂直传播,导致婴儿患上先天性寨卡综合征。因此,调查母亲及其新生儿的临床流行病学概况是很重要的。目的:描述妊娠期与寨卡病毒推定相关的孕妇及其出生时被诊断为小头畸形并与cz相关的新生儿的临床-流行病学特征。方法:采用2015年9月至2016年6月期间的病历资料进行横断面研究。结果:本组共报告产妇小头畸形82例。根据世界卫生组织(世卫组织)和巴西卫生部的说法,其中32例因不符合新的小头畸形标准而被排除在外。产妇平均年龄为25岁,从13岁到43岁不等;麻疹是与寨卡病毒感染相关的唯一症状,在60%(27/45)的妊娠中观察到该病,主要发生在妊娠的前三个月或中期。其他母亲则没有症状。与新生儿相关,62%(31/50)为女性;32%(16/50)体重过轻;2%(1/50)早产儿。新生儿脑超声显示异常的新生儿占74%(31/44),以钙化为主,87%(27/31)。29例新生儿行盆底镜检查,其中38%(11/29)异常。结论:尽管大多数孕妇没有虫媒病毒的典型症状,因此在临床实践中很难通过血清学怀疑和确认寨卡病毒感染,重要的是要了解与寨卡病毒感染和cchs相关的临床和流行病学特征,以便确定应指导和更好地调查预防措施的地点,并根据其结果对受感染的新生儿进行适当的随访。
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Clinical and epidemiological profile of the mother–neonate binomy with microcefalia and suspected infection by zika viruses in the gestation: a sectional study
Introduction: The association between the increased incidence of microcephaly and the epidemic outbreak of Zika virus infection (ZIKV) in Brazil between 2015 and 2016 was observed by many authors. World Health Organization declared it as a public health emergency of international concern. Maternal infection with the Zika virus can be transmitted vertically and lead to Congenital Zika Syndrome (CZS) in infants. So that it is important to investigate the clinical-epidemiological profile of the mothers and their newborns. Aims: To characterize the clinical- epidemiological profile of pregnant women associated with presumed ZIKV in pregnancy and their newborns diagnosed with microcephaly at birth and associated with CZS. Methods: A sectional study, using medical record data, between September 2015 and June 2016. Results: 82 cases of microcephaly were reported in maternity during this period. Of these, 32 cases were excluded because they did not fit the new microcephaly criteria according to the World Health Organization (WHO) and the Ministry of Health of Brazil. The mean maternal age was 25 years, varying from 13 and 43 years old; exanthema was the only symptom related to Zika virus infection and it was observed in 60% (27/45) of the pregnancies, which occurred predominantly during the first or the second trimester of pregnancy. Other mothers were asymptomatic. Related to the newborns, 62% (31/50) were female; 32% (16/50) were low weight; 2% (1/50) were premature. Neonatal brain ultrasound showed 70,4% (31/44) of the neonates with abnormal findings, mainly calcifications that occurred in 87% (27/31). 29 newborns were submitted to fundoscopy examinations and 38% (11/29) were abnormal. Conclusion: Despite the majority of pregnant women did not have classic symptoms of arboviruses and because of this the suspicion and confirmation of Zika viruses infection through serologies are difficult in clinical practice, it is important to understand clinical and epidemiological characteristics related to Zika viruses infection and the CZS to allow mapping where preventive measures should be directed and better investigated as well as to offer an adequate follow-up to the infected neonates according to their outcomes.
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