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© 2021 Aguilar Ticona et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Objective

To describe the neurological and neurodevelopmental outcomes of children with Congenital Zika Syndrome (CZS) associated microcephaly beyond 2 years of age.

Method

We followed children with CZS-associated microcephaly in an outpatient clinic in Salvador, Brazil. Neurological and neurodevelopmental assessments were performed using the Hammersmith Infant Neurological Examination (HINE) and Bayley Scales of Infant and Toddler Neurodevelopment (Bayley-III) respectively.

Results

Of the 42 children included, 19 were male (45.2%); median (interquartile range) age at neurological evaluation was 28 (25–32) months, and 36 (85.7%) had severe microcephaly. HINE and Bayley-III results were completed for 35/42 (83.3%) and 33/42 (78.5%) children respectively. Bayley-III identified a severe developmental delay in 32/33 (97.0%) children while 1/33 (3.0%) had only a mild delay. In the multivariable analysis, we found that Bayley-III and HINE scores were correlated. Better HINE scores were associated with higher Bayley-III cognitive raw scores (β = 0.29; CI 95% = 0.02–0.57) and motor raw scores (β = 0.43; CI 95% = 0.04–0.82) after adjusting for head circumference, prematurity, and age at neurodevelopmental evaluation. Furthermore, we found that greater head circumference at follow up was associated with higher cognitive (β = 1.27; CI 95% = 0.01–2.53) and motor raw scores (β = 2.03; CI 95% = 0.25–3.81).

Conclusion

Children with CZS-associated microcephaly demonstrate severe neurodevelopmental delays and slower growth rates than their peers over time. Still, they have remarkably heterogeneous neurodevelopmental profiles according to neurological exam scores which correlate with their long-term outcomes. We found that HINE scores effectively captured the heterogeneity of neurological capabilities among these children and could be predictive of cognitive and motor development progress.

Details

Title
Heterogeneous development of children with Congenital Zika Syndrome-associated microcephaly
Author
Aguilar Ticona, Juan P; Nery, Nivison, Jr; Doss-Gollin, Simon; Gambrah, Claudia; Lessa, Millani; Rastely-Júnior, Valmir; Matos, Adriana; de Paula Freitas, Bruno; Borja, Ana; Wunder, Elsio A, Jr; Ballalai, Verena; Vieira, Carina; Cruz, Jaqueline S; de Oliveira, Daiana; Danielle Bastos Araujo; Oliveira, Danielle B; Denicar Lina Nascimento Fabris Maeda; Mendes, Erica A; Camila Pereira Soares; Durigon, Edison L; Luis Carlos de Souza Ferreira; Belfort, Rubens; Almeida, Antonio R P; Oliveira-Filho, Jamary; Reis, Mitermayer G; Ko, Albert I; Costa, Federico
First page
e0256444
Section
Research Article
Publication year
2021
Publication date
Sep 2021
Publisher
Public Library of Science
e-ISSN
19326203
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2572893304
Copyright
© 2021 Aguilar Ticona et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.