Arrais Nivia M R, Maia Claudia R S, Jerômino Selma M B, Neri João I C F, Melo Áurea N, Bezerra Mylena T A L, de Moraes-Pinto Maria Isabel
From the Department of Pediatrics, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
Division of Pediatric Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil.
Pediatr Infect Dis J. 2025 May 1;44(5):465-472. doi: 10.1097/INF.0000000000004706. Epub 2025 Jan 24.
Little is known about the clinical course of children born with congenital Zika virus syndrome (CZS). This article aimed to analyze the growth and survival of children with CZS born with microcephaly and children who developed with microcephaly after birth in the 36-month period.
This is a cohort of children diagnosed with CZS who were monitored in a series of outpatient appointments, with clinical and demographic information and anthropometric measurements collected. The Mann-Kendall test evaluated the trend of the mean Z-score of head circumference (HC) for age and the Kaplan-Meier model described the time to low weight and short length according to the classification of HC at birth.
Children born without microcephaly had a reduction in HC growth velocity ( P = 0.019) and took longer to reach low weight ( P = 0.036) and short length ( P = 0.034) when compared with those born with microcephaly. Seven (10%) deaths were reported, and the probability of survival after 36 months of age was 88%. In children with arthrogryposis, the risk of death was 7 times as high as in those without this condition (adjusted hazard ratio: 6.49; 95% confidence interval: 1.31-32.20; P = 0.022).
In this cohort of children with CZS, 20% were born without microcephaly and all of them presented a reduction in HC growth velocity, which led to microcephaly. Progression to low weight and short length occurred in the first years of life, and that was faster in those born with microcephaly. Healthcare providers should be aware of these conditions that pose a risk of unfavorable anthropometric measurements and death.
关于先天性寨卡病毒综合征（CZS）患儿的临床病程知之甚少。本文旨在分析出生时即患有小头畸形的CZS患儿以及出生后出现小头畸形的患儿在36个月期间的生长和生存情况。
这是一组被诊断为CZS的患儿队列，通过一系列门诊预约进行监测，收集临床和人口统计学信息以及人体测量数据。Mann-Kendall检验评估了年龄别头围（HC）平均Z评分的趋势，Kaplan-Meier模型根据出生时HC的分类描述了达到低体重和短身长的时间。
与出生时即患有小头畸形的患儿相比，出生时无小头畸形的患儿HC生长速度降低（P = 0.019），达到低体重（P = 0.036）和短身长（P = 0.034）所需时间更长。报告了7例（10%）死亡病例，36个月龄后的生存概率为88%。在患有关节挛缩症的患儿中，死亡风险是未患此病患儿的7倍（调整后风险比：6.49；95%置信区间：1.31 - 32.20；P = 0.022）。
在这组CZS患儿中，20%出生时无小头畸形，且所有患儿HC生长速度均降低，进而导致小头畸形。在生命的头几年出现了体重降低和身长缩短的情况，且出生时即患有小头畸形的患儿情况发展更快。医疗保健提供者应了解这些会带来人体测量结果不佳和死亡风险的情况。
