Orthopedic abnormalities in patients presenting with Congenital Zika syndrome: an analysis of 157 patients

Abstract

Purpose: The study aimed to describe the characteristics of orthopedic examination in patients with microcephaly associated with congenital infection by the Zika virus, the epidemiological profile, the characteristics of orthopedic disorders, and their relationship to pregnancy. Methodology: We reviewed 157 medical records of infants with microcephaly treated at AACD / PE. All the patients had positive serology for Zika vírus infection, and those with positive serology for another condition or incomplete records data were excluded. Physical exam findings were divided into primary and secondary orthopedics abnormalities and were analyzed by the prevalence. Hypothesis testing for proportions was utilized to verify possible associations between the time of infection (before or after the first trimester) and the presence or absence of musculoskeletal abnormalities present at birth. Results: After reviewing patient data, we found a prevalence of abnormal orthopedic findings in 66,88%. The lower limbs were the most commonly affected area. We also found an abnormally high incidence of arthrogryposis and developmental hip dysplasia, which was the most prevalent one. Most patients presented with more than one deformity. We also found that the association between the time of infection at an early gestational age and the presence of orthopedic deformities was statistically significant. Conclusion: The present research described the main orthopedic alterations found in the physical exam of newborns with microcephaly associated with congenital infection by the Zika Virus, giving special attention to alterations in the lower limbs, and in line with other congenital infections, the gestational period that has the greatest potential to cause changes in the normal development of the child is the first trimester