新生儿小头症和中枢神经系统异常 在里约热内卢寨卡疫情期间
Marlos Melo Martins1, Roberto de Andrade Medronho2, Carlos Eduardo Raymundo2
1Division of Pediatric Neurology, Martagão Gesteira Institute of Childcare and Pediatrics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, Brazil.
Viruses
|February 26, 2025
概括
在怀孕期间感染寨卡病毒 (ZIKV) 显著增加了新生儿先天性神经系统 (CNS) 异常的风险. 怀孕早期的暴露构成最高风险,需要对受影响的婴儿进行警监测.
科学领域:
- 神经科学是一个神经科学.
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 寨卡病毒 (ZIKV) 对孕妇构成重大威胁,可能对胎儿发育造成严重后果.
- 遗传性寨卡综合征 (CZS) 涵盖了在子宫内暴露于ZIKV的婴儿的一系列神经和身体异常.
- 对于有效的公共卫生策略来说,了解不同怀孕阶段与ZIKV感染相关的确切风险至关重要.
研究的目的:
- 量化怀孕期间ZIKV感染与先天性小头症和其他中枢神经系统 (CNS) 异常发生之间的关联.
- 为了确定这些异常的风险是否取决于发生ZIKV感染的妊娠三个月而有所不同.
- 为了确定与子宫内ZIKV暴露相关的神经发育和结构异常的频谱.
主要方法:
- 追溯队列研究分析了巴西里约热内卢7870名孕妇的数据.
- 利用倾向得分模型来控制混因素,并按怀孕季度对结果进行分层.
- 包括2269名已确认感染ZIKV的妇女和5601名对照,检查胎儿和新生儿的结果.
主要成果:
- 与未感染女性 (0.78%) 相比,感染ZIKV的孕妇患先天性小头或中枢神经系统异常的发病率显著更高 (2.16%).
- 中枢神经系统异常的调整后几率比为2.46整体,在第一季度 (4.29) 和第二季度 (5.29) 的风险明显更高.
- 常见的发现包括内结,腹腔大,体形,以及明显的眼科 (55.5%) 和听觉 (33.3%) 缺陷.
结论:
- 怀孕期间的ZIKV感染是新生儿结构和功能异常的确诊原因.
- 患有先天性寨卡综合征的风险在第一和第二季度感染时最明显.
- 临床管理应侧重于在子宫内暴露于ZIKV的婴儿的神经,感官和运动缺陷的积极监测和支持性护理.
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