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Early Clinical Infancy Outcomes for Microcephaly and/or Small for Gestational Age Zika-Exposed Infants

Kristina Adachi1, Tahmineh Romero2, Karin Nielsen-Saines1

  • 1Department of Pediatrics, David Geffen School of Medicine, University of California-Los Angeles, California, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 27, 2019
PubMed

Insights

Zika virus (ZIKV) exposure in infants can lead to microcephaly or being small for gestational age (SGA), increasing risks for adverse outcomes. Close monitoring of growth trajectories is crucial for these infants during their first year.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Antenatal Zika virus (ZIKV) exposure is linked to adverse infant outcomes, including microcephaly and being small for gestational age (SGA).
  • ZIKV-exposed infants require close monitoring for growth and potential health complications.

Purpose of the Study:

  • To evaluate anthropometric measurements and health outcomes in ZIKV-exposed infants with microcephaly (proportional [PM] or disproportional [DM]) or SGA.
  • To assess the growth trajectories and adverse outcomes in the first year of life for these infants.

Main Methods:

  • Laboratory-confirmed ZIKV exposure in infants in Brazil.
  • Classification of infants into PM, DM, or SGA based on head circumference and weight.
  • Recording and analysis of first-year growth parameters and clinical outcomes.

Main Results:

  • High rates of neurological, ophthalmologic, and hearing abnormalities were observed in PM (100%), DM (100%), and SGA (42.9%) infants compared to non-SGA/non-microcephalic (NSNM) infants (18.3%).
  • Neuroimaging abnormalities were prevalent in PM (100%), DM (100%), and SGA (42.9%) infants.
  • Growth rates were initially poor for microcephalic infants but improved after 4 months.

Conclusions:

  • ZIKV-exposed infants with microcephaly (PM/DM) and SGA face significant risks for adverse outcomes in the first year.
  • SGA infants had fewer adverse outcomes than microcephalic infants but still showed increased odds (3-4 times) compared to NSNM infants.
  • Continuous monitoring of growth trajectories is essential for ZIKV-exposed infants with microcephaly or SGA.
Abstract

Keywords:
Zikacongenital Zika syndromemicrocephalyproportional microcephalysmall for gestational age (SGA)

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