Gross motor function in children with Congenital Zika Syndrome from Rio de Janeiro, Brazil
Carla Trevisan M Ribeiro1, Tatiana Hamanaka2, Sheila Pone2
1National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro, 22250-020, Brazil. carla.ribeiro@iff.fiocruz.br.
Insights
Most children with Congenital Zika Syndrome (CZS) experience severe motor impairments, significantly impacting their development and prognosis. Early assessment of gross motor function is crucial for guiding management and understanding long-term outcomes in affected infants.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Infectious Diseases
Background:
- Congenital Zika Syndrome (CZS) presents significant central nervous system impairments.
- These impairments can severely affect neurodevelopment and increase morbidity in children.
- Understanding gross motor function is critical for managing CZS.
Purpose of the Study:
- To assess the gross motor function of children diagnosed with Congenital Zika Syndrome.
- To correlate motor function with the severity of neurological impairment in CZS.
- To provide insights into the prognosis and functional limitations associated with CZS.
Main Methods:
- Cross-sectional investigation within a prospective cohort study.
- Gross motor function assessed using the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM).
- Analysis included 72 children with CZS in Rio de Janeiro, Brazil.
Main Results:
- The majority of children (87.5%) exhibited severe motor impairment.
- Statistically significant differences in GMFM scores were observed across GMFCS levels (p < 0.001).
- Severe impairment was associated with microcephaly; milder forms allowed for walking skills development.
Conclusions:
- Most children with CZS present with major motor disabilities and have a poor prognosis.
- Gross motor function assessment aids in understanding limitations and serves as a prognostic guide.
- Further research can refine management strategies for children with CZS.
Abstract:
Congenital Zika Syndrome (CZS) is characterized by many impairments especially in the central nervous system, potentially compromising neurodevelopment and causing significant morbidity in affected children. The aim was to assess gross motor function in children with CZS. This was a cross-sectional investigation nested within a prospective cohort study of children with CZS based in a Brazilian referral hospital in Rio de Janeiro. Between March/2017 and February/2018, we performed gross motor function assessments using the Gross Motor Function Classification (GMFCS) and the Gross Motor Function Measure (GMFM), estimating the mean and standard deviation of GMFM scores among GMFCS groups. The study sample included 72 children, with a median age of 13 months (7-25). Of these, 63 (87.5%) had severe motor impairment, 3 (4%) had moderate impairment, and 6 (8%) had mild impairment. The mean GMFM score for each group was respectively 11.6, 26.1, and 81.6, with statistically significant differences (p-value < 0.001). Severely affected children only achieved head control in the sitting posture when supported. Children with milder forms were able to develop walking skills.Conclusion: Most children with CZS have major motor disabilities and a poor prognosis. Better understanding of limitations and functionality in children with CZS can serve as a prognostic guide in their management. What is Known: • Severe motor impairment was present in 63 (87.5%) children with CZS. • The degree of neurological impairment was inversely associated with motor performance. What is New: • Microcephaly was more frequent among children with severe gross motor function impairment. • Children with CZS have major motor disabilities and a poor prognosis.
