巴西确诊或疑似先天性寨卡病毒感染儿童的围产期特征及长期预后：寨卡行动儿科登记处
Perinatal characteristics and longer-term outcomes in Brazilian children with confirmed or suspected congenital Zika infection: ZIKAction Paediatric Registry.
作者信息
de Siqueira Isadora Cristina, de Almeida Breno Lima, Lage Maria Lucia Costa, Serra Leticia, Carvalho Alessandra, de Lima Maricélia Maia, Góes Maria de Fatima Neri, Crispim Marília De Santa Inês Neri, da Costa Pereira Mirela Monteiro, Costa Bernardo Gratival Gouvea, Bailey Heather, Byrne Thomas, Giaquinto Carlo, Fernandes Georgina, Ruiz-Burga Elisa, Thorne Claire
机构信息
Instituto Gonçalo Moniz-Fiocruz, Rua Waldemar Falcão, 121, Candeal, Salvador, BA, Brazil.
Centro de Prevenção e Reabilitação da Pessoa com Deficiência - Cepred, Av. Antônio Carlos Magalhães, S/N, Parque Bela Vista, 40279-700 Salvador, BA, Brazil.
出版信息
Dialogues Health. 2023 Jan 20;2:100104. doi: 10.1016/j.dialog.2023.100104. eCollection 2023 Dec.
BACKGROUND
Despite growing scientific knowledge of Zika virus (ZIKV) infection, questions remain regarding ZIKV infection in pregnancy and congenital ZIKV syndrome (CZS).
METHODS
The ZIKAction Paediatric Registry is an international registry of children with documented ZIKV exposure in utero and/or with confirmed or suspected CZS. Its aim is to characterize these children (i.e., clinical, radiological, neurodevelopmental features) and describe outcomes, longer-term sequelae and management through retrospective case note review. This analysis described the maternal and perinatal characteristics of children in the Registry's Bahia arm, assessed their neuroimaging, ophthalmic, hearing and electroencephalography abnormalities by microcephaly classification and reported on hospitalisations. Children born in 2015-2018 and enrolled 2020-2021 in three public health facilities in Salvador were included.
RESULTS
Of 129 (57% female) children, 15 (11·6%) had laboratory-confirmed congenital ZIKV infection and 114 (88·4%) suspected CZS. At delivery, 15 (11·6%) were normocephalic, 30 (23·3%) moderately microcephalic, and 84 (65·1%) severely microcephalic. Median birth head circumference z-score was -3·51 [IQR, -4·69,-2·73]. During follow-up, all children had abnormal neuroimaging, 80·3% (94/117) abnormal electroencephalogram, 62·2% (77/120) ophthalmic abnormalities, and 27·4% (34/124) hearing impairment. Microcephaly classification was significantly associated with gestational age, and ophthalmological and electroencephalography abnormalities. Of 125 children with hospitalisation data, 52 (41·6%) had been hospitalised by most recent follow-up, at median age of 15·8 [4·0, 34·4] months; infections were the leading cause.
CONCLUSION
Congenital ZIKV infection is an emerging disease with a varied and incompletely understood spectrum. Continued long-term follow-up is essential to understand longer-term prognosis and to inform future health and educational needs.
背景
尽管对寨卡病毒（ZIKV）感染的科学认识不断增加，但关于孕期寨卡病毒感染和先天性寨卡病毒综合征（CZS）仍存在问题。
方法
ZIKAction儿科登记处是一个国际登记处，登记有子宫内接触寨卡病毒记录和/或确诊或疑似先天性寨卡病毒综合征的儿童。其目的是通过回顾性病例记录审查来描述这些儿童的特征（即临床、放射学、神经发育特征），并描述其结局、长期后遗症及管理情况。本分析描述了登记处巴伊亚分部儿童的母亲和围产期特征，按小头畸形分类评估了他们的神经影像学、眼科、听力和脑电图异常情况，并报告了住院情况。纳入了2015 - 2018年出生且于2020 - 2021年在萨尔瓦多的三个公共卫生机构登记的儿童。
结果
在129名儿童中（57%为女性），15名（11.6%）有实验室确诊的先天性寨卡病毒感染，114名（88.4%）疑似先天性寨卡病毒综合征。分娩时，15名（11.6%）头围正常，30名（23.3%）中度小头畸形，84名（65.1%）重度小头畸形。出生时头围z评分中位数为 -3.51[四分位间距，-4.69，-2.73]。在随访期间，所有儿童均有神经影像学异常，80.3%（94/117）脑电图异常，62.2%（77/120）有眼科异常，27.4%（34/124）有听力障碍。小头畸形分类与孕周、眼科和脑电图异常显著相关。在有住院数据的125名儿童中，52名（41.6%）在最近一次随访时已住院，中位年龄为15.8[4.0，34.4]个月；感染是主要原因。
结论
先天性寨卡病毒感染是一种新出现的疾病，其谱型多样且尚未完全了解。持续的长期随访对于了解长期预后以及为未来的健康和教育需求提供信息至关重要。
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