Clinical and epidemiological profile of the mother–neonate binomy with microcefalia and suspected infection by zika viruses in the gestation: a sectional study

Abstract

Introduction: The association between the increased incidence of microcephaly and the epidemic outbreak of Zika virus infection (ZIKV) in Brazil between 2015 and 2016 was observed by many authors. World Health Organization declared it as a public health emergency of international concern. Maternal infection with the Zika virus can be transmitted vertically and lead to Congenital Zika Syndrome (CZS) in infants. So that it is important to investigate the clinical-epidemiological profile of the mothers and their newborns. Aims: To characterize the clinical- epidemiological profile of pregnant women associated with presumed ZIKV in pregnancy and their newborns diagnosed with microcephaly at birth and associated with CZS. Methods: A sectional study, using medical record data, between September 2015 and June 2016. Results: 82 cases of microcephaly were reported in maternity during this period. Of these, 32 cases were excluded because they did not fit the new microcephaly criteria according to the World Health Organization (WHO) and the Ministry of Health of Brazil. The mean maternal age was 25 years, varying from 13 and 43 years old; exanthema was the only symptom related to Zika virus infection and it was observed in 60% (27/45) of the pregnancies, which occurred predominantly during the first or the second trimester of pregnancy. Other mothers were asymptomatic. Related to the newborns, 62% (31/50) were female; 32% (16/50) were low weight; 2% (1/50) were premature. Neonatal brain ultrasound showed 70,4% (31/44) of the neonates with abnormal findings, mainly calcifications that occurred in 87% (27/31). 29 newborns were submitted to fundoscopy examinations and 38% (11/29) were abnormal. Conclusion: Despite the majority of pregnant women did not have classic symptoms of arboviruses and because of this the suspicion and confirmation of Zika viruses infection through serologies are difficult in clinical practice, it is important to understand clinical and epidemiological characteristics related to Zika viruses infection and the CZS to allow mapping where preventive measures should be directed and better investigated as well as to offer an adequate follow-up to the infected neonates according to their outcomes.