Decline in head circumference growth and associated factors in congenital Zika syndrome
Eliana Harumi Morioka Takahasi1,2, Maria Teresa Seabra Soares de Britto E Alves1, Marizélia Rodrigues Costa Ribeiro3
1Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, Brasil.
Insights
Head circumference (HC) in children with congenital Zika syndrome (CZS) significantly decreases in the first three months. Severe brain atrophy and early maternal infection worsen head growth prognosis in these children.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Congenital Zika syndrome (CZS) impacts child development, but head circumference (HC) evolution is poorly understood.
- Early identification of growth patterns is crucial for managing CZS.
- Limited data exists on HC changes in the first three years of life for CZS children.
Purpose of the Study:
- To evaluate head circumference (HC) growth in children with CZS during their first three years.
- To identify factors associated with HC z-score changes in CZS.
- To understand the implications of HC growth for central nervous system development.
Main Methods:
- Retrospective analysis of HC data from 74 CZS children (birth to 3 years).
- Data sourced from Child's Health Handbook, parental reports, and medical records.
- Mixed-effects models and Akaike's information criterion used for statistical analysis.
Main Results:
- HC z-score declined from -2.7 at birth to -5.5 at 3 months, then stabilized.
- Severe brain parenchymal atrophy was linked to reduced HC z-score.
- Maternal infection symptoms in the first trimester correlated with a worse HC z-score prognosis.
Conclusions:
- The rapid HC z-score decrease in early infancy suggests impaired central nervous system growth in CZS.
- Head growth prognosis is poorer with severe brain atrophy and first-trimester maternal infection.
- Early gestational Zika virus exposure significantly affects long-term head development in affected children.
Abstract:
Little is known about the evolution of head circumference (HC) in children with congenital Zika syndrome (CZS). This study aims to evaluate HC growth in children with CZS in the first three years of life and identify associated factors. HC data obtained at birth and in neuropediatric consultations from 74 children with CZS were collected from the Child's Health Handbook, parents' reports, and medical records. Predictors of HC z-score were investigated using different mixed-effects models; Akaike's information criterion was used for model selection. The HC z-score decreased from -2.7 ± 1.6 at birth to -5.5 ± 2.2 at 3 months of age, remaining relatively stable thereafter. In the selected adjusted model, the presence of severe brain parenchymal atrophy and maternal symptoms of infection in the first trimester of pregnancy were associated with a more pronounced reduction in the HC z-score in the first three years of life. The decrease of HC z-score in CZS children over the first three months demonstrated a reduced potential for growth and development of the central nervous system of these children. The prognosis of head growth in the first 3 years of life is worse when maternal infection occurs in the first gestational trimester and in children who have severe brain parenchymal atrophy.
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