Defining dysmorphic facial features in congenital Zika syndrome
Cristiane Sá Roriz Fonteles1, Francisco César Monteiro1, Rebeca Bastos Vasconcelos1
1Faculty of Pharmacy Dentistry and Nursing, Postgraduate Program in Dentistry, Federal University of Ceara, Fortaleza, Brazil.
Insights
Facial analysis of children with Congenital Zika syndrome (CZS) revealed distinct dysmorphisms. Increased chin height index showed high accuracy in diagnosing CZS, aiding in identifying affected infants.
Area of Science:
- Medical Genetics
- Pediatrics
- Virology
Background:
- Congenital Zika syndrome (CZS) is a malformation linked to prenatal Zika virus infection.
- Limited research exists on the specific facial dysmorphic features associated with CZS.
- Understanding these features is crucial for diagnosis and management of affected children.
Purpose of the Study:
- To evaluate and compare facial dysmorphic features in children with CZS versus healthy controls.
- To identify specific anthropometric indices that differentiate CZS patients.
- To assess the diagnostic potential of these facial features for CZS.
Main Methods:
- Clinical examination and standardized photographic analysis were used.
- Sixty-three children with CZS and 31 healthy controls participated.
- Fifteen facial anthropometric indices were measured and compared between groups.
Main Results:
- Seven of the 15 facial indices significantly differed between CZS patients and controls.
- Children with CZS exhibited broad, short faces, decreased intercanthal distance, and high-set, long ears.
- A chin height/total facial height (CH/TFH) index of 0.229 demonstrated high sensitivity (93.9%) and specificity (80.6%) for CZS diagnosis.
Conclusions:
- Distinct facial dysmorphic features are characteristic of Congenital Zika syndrome.
- The chin height index is a highly accurate anthropometric marker for diagnosing CZS.
- Further research into facial morphology can aid in early identification and intervention for CZS.
Abstract:
Congenital Zika syndrome (CZS) constitutes a recently identified malformation caused by Zika virus infection during pregnancy. Limited data is available to date on the facial dysmorphic features of these patients. This study evaluated the facial dysmorphisms of children with CZS, compared with clinically healthy children, using clinical examination and standardized photographic images. Sixty-three children with CZS (9.70 ± 3.2 months-age), and 31 Controls (8.67 ± 6.2 months-age) joined the study. Seven out of 15 indices differed between groups: midfacial height (MFH)/horizontal facial reference (HFR) (p = .0003), interalar distance/HFR (p = .0027), nasal root depth/MFH (p = .0030), posterior nasal length/MFH (p = .0002), vertical position of the ear/MFH (p <.0001), ear length/MFH (p = .0005), chin height/total facial height (CH/TFH) (p <.0001). A CH/TFH of 0.229 showed 93.9% sensitivity and 80.6% specificity in diagnosing CZS. Children with CZS had broad, short faces, decreased intercanthal distance, short posterior nasal length, prominent nasal root, broad nasal wings, and high-set and long ears. Increased chin height index provided the most accurate diagnostic potential.
