Malnutrition in Children with Congenital Zika Virus Syndrome: A Systematic Review
Deysiane Santiago da Silva1, Letícia Karla Cunha Dos Santos2, Suamy Sales Barbosa3
1Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Insights
Growth deviations and malnutrition are prevalent in children with Congenital Zika virus Syndrome (CZS). Factors like feeding practices significantly impact these conditions, highlighting the need for targeted interventions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Congenital Zika virus Syndrome (CZS) presents significant health challenges for affected children.
- Growth deviations and malnutrition are common concerns in pediatric populations with chronic conditions.
Purpose of the Study:
- To systematically review existing literature on growth deviations in children with CZS.
- To identify factors associated with malnutrition in children diagnosed with CZS.
Main Methods:
- A systematic review was conducted, registering the protocol on PROSPERO (CRD42023460505).
- Searches encompassed multiple databases (PubMed, Scopus, Embase, LILACS, SciELO) and repositories for observational studies (2010-2023).
- Included studies focused on children with CZS and microcephaly, analyzing anthropometric z-scores and malnutrition-associated factors.
Main Results:
- Eleven studies involving children aged 0-48 months were analyzed.
- Malnutrition rates included stunting (14.3%-57.1%), underweight (14.3%-54.4%), wasting (4.3%-48.0%), and overweight (4.6%-68.6%).
- Associations were found with dysphagia, breastfeeding, feeding practices, and diet.
Conclusions:
- Children with CZS exhibit short stature, wasting, and overweight.
- Inappropriate feeding practices are linked to adverse nutritional outcomes in CZS.
Objective:
We examined previous studies to describe growth deviations in children with Congenital Zika virus Syndrome (CZS), and to determine the factors associated with malnutrition.
Study Design:
Protocol of systematic review registered on the PROSPERO platform under code CRD42023460505. The searches were conducted in SciELO, LILACS, Embase, Scopus, and PubMed/MEDLINE databases, as well as in dissertation and thesis repositories. The eligibility criteria required that the publications must be observational, cross-sectional, cohort, or case-control studies conducted with children with microcephaly associated with CZS, which presented results (z-score) of anthropometric indices of weight-for-age, height-for-age, weight-for-height, and/or body mass index (BMI)-for-age; written in English, Portuguese, or Spanish; and published between 2010 and 2023. The z-score values from anthropometric indices and the factors associated with malnutrition (wasting, underweight, overweight, or stunting) were extracted.
Results:
Eleven studies met our inclusion criteria. In these studies, children's ages ranged from 0 to 48 months. Malnutrition was identified as stunting (14.3% to 57.1%), underweight (14.3% to 54.4%), wasting (4.3% to 48.0%), and, to a lesser extent, as overweight (4.6% to 68.6%). The association of these indices was examined in relation to dysphagia, absence or duration of breastfeeding, delayed introduction of complementary feeding, consumption of ultra-processed foods, and feeding route.
Conclusion:
It was possible to identify short stature, wasting, excess weight, and inappropriate eating practices in children with CZS.
