Anthropometric Parameters of Children with Congenital Zika Virus Exposure in the First Three Years of Life
Elisa Barroso de Aguiar1, Sheila Moura Pone1, Saint Clair Dos Santos Gomes Junior1
1National Institute of Women, Children and Adolescents' Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil.
Insights
Congenital Zika virus (ZIKV) exposure significantly impacts early childhood growth. Children with congenital Zika syndrome (CZS) experienced severe growth deficits, unlike those without CZS, who showed normal development.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Congenital Zika virus (ZIKV) exposure's long-term effects on child development are not well understood.
- Zika virus infection during pregnancy can lead to congenital Zika syndrome (CZS).
Purpose of the Study:
- To evaluate the impact of ZIKV exposure on growth in the first three years of life.
- To compare growth parameters between children with CZS and those without (NCZS) against WHO standards.
Main Methods:
- Prospective cohort study of 201 ZIKV-exposed children in Rio de Janeiro, Brazil.
- Classified children into CZS (n=87) and NCZS (n=114) groups.
- Monitored growth parameters (weight, length, W/H, BMI) and compared them to WHO growth curves.
Main Results:
- 39% of CZS newborns were small for gestational age versus 6% in NCZS (p < 0.001).
- CZS children exhibited significantly lower weight and length z-scores throughout follow-up compared to NCZS children (p < 0.001).
- Over 50% of CZS children aged 25-36 months were below weight and height limits; 37.1% were below the weight/height cut-off.
Conclusions:
- Congenital Zika virus exposure leads to severe and early growth deficits in children with CZS.
- Children with CZS often require nutritional support, such as gastrostomy (26% in this cohort).
- NCZS children demonstrated normal growth patterns according to WHO standards.
Abstract:
Little is known about the impact of congenital Zika virus (ZIKV) exposure on growth in the first years of life. In this prospective cohort study,201 ZIKV antenatally-exposed children were followed at a tertiary referral center in Rio de Janeiro, Brazil. Eighty-seven were classified as congenital Zika syndrome (CZS) patients and 114 as not congenital Zika syndrome (NCZS); growth parameters were described and compared between groups and with WHO standard growth curves. Thirty-four (39%) newborns with CZS and seven (6%) NCZS were small for gestational age (p < 0.001). NCZS mean weight measures ranged from −0.45 ± 0.1 to 0.27 ± 0.2 standard deviations (SD) from the WHO growth curve median during follow-up, versus −1.84 ± 0.2 to −2.15 ± 0.2 SD for the CZS group (p < 0.001). Length mean z-scores varied from −0.3 ± 0.1 at 1 month to 0.17 ± 0.2 SD between 31 and 36 months in the NCZS group, versus −2.3 ± 0.3 to −2.0 ± 0.17 SD in the CZS group (p < 0.001). Weight/height (W/H) and BMI z-scores reached -1.45 ± 0.2 SD in CZS patients between 31 and 36 months, versus 0.23 ± 0.2 SD in the NCZS group (p < 0.01). Between 25 and 36 months of age, more than 50% of the 70 evaluated CZS children were below weight and height limits; 36 (37.1%) were below the W/H cut-off. Gastrostomy was performed in 23 (26%) children with CZS. During the first three years of life, CZS patients had severe and early growth deficits, while growth of NCZS children was normal by WHO standards.
