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Congenital Zika syndrome: association between the gestational trimester of maternal infection, severity of brain computed tomography findings and microcephaly at birth
This study analyzed possible associations between the trimester of maternal Zika virus infection (ZIKV) in pregnancy, severity of brain computed tomography (CT) findings and the presence of microcephaly at birth in children with Congenital Zika Syndrome (CZS). It was an analytical study in a cohort...
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Published in: | Revista do Instituto de Medicina Tropical de São Paulo 2020-01, Vol.62, p.1-8 |
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creator | Mendes, Ana Karolina Torres Ribeiro, Marizélia Rodrigues Costa Lamy-Filho, Fernando Amaral, Gláucio Andrade Borges, Marcella Costa Ribeiro Costa, Luciana Cavalcante Cavalcante, Tamires Barradas Batista, Rosângela Fernandes Lucena Sousa, Patrícia da Silva Silva, Antônio Augusto Moura da |
description | This study analyzed possible associations between the trimester of maternal Zika virus infection (ZIKV) in pregnancy, severity of brain computed tomography (CT) findings and the presence of microcephaly at birth in children with Congenital Zika Syndrome (CZS). It was an analytical study in a cohort of children with CZS. Symptoms of maternal infection were dichotomized into the 1
st
trimester of pregnancy and other trimesters. Head circumference (HC) at birth was used to calculate the z-score. Mild microcephaly was defined as HC between 2 and ≥3 standard deviations (SD) below the mean for each gestational age and sex, and severe microcephaly when HC |
doi_str_mv | 10.1590/s1678-9946202062056 |
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st
trimester of pregnancy and other trimesters. Head circumference (HC) at birth was used to calculate the z-score. Mild microcephaly was defined as HC between 2 and ≥3 standard deviations (SD) below the mean for each gestational age and sex, and severe microcephaly when HC <3 SD below average. Brain CT images were evaluated by two radiologists and classified, according to the severity, into mild, moderate and severe. Fisher’s exact, Mann-Whitney and Kruskal-Wallis tests were used to verify the associations between variables. In 108 children, maternal infection in the 1
st
trimester of pregnancy was associated with more severe brain CT abnormalities (p=0.038), greater severity of microcephaly at birth (p=0.013) and lower HC z-scores at birth (p=0.021). The severity of brain CT lesions was also associated with lower HC z-scores at birth (p<0.001). Maternal ZIKV infection during the first trimester of pregnancy proved to be an important risk factor for a more severe spectrum of CZS, as it is associated with more severe brain CT abnormalities and, consequently, with lower HC z-scores at birth.</description><identifier>ISSN: 1678-9946</identifier><identifier>ISSN: 0036-4665</identifier><identifier>EISSN: 1678-9946</identifier><identifier>DOI: 10.1590/s1678-9946202062056</identifier><identifier>PMID: 32844907</identifier><language>eng</language><publisher>São Paulo: Instituto de Medicina Tropical de Sao Paulo</publisher><subject>Brain computed tomography ; Congenital abnormalities ; Microcephaly ; Original ; TROPICAL MEDICINE ; Zika virus ; Zika virus infection</subject><ispartof>Revista do Instituto de Medicina Tropical de São Paulo, 2020-01, Vol.62, p.1-8</ispartof><rights>2020. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c581t-97eaa5ce92bf3b33b59f05622966712748f3cc85388495a062a2242ec4ee6bd83</citedby><cites>FETCH-LOGICAL-c581t-97eaa5ce92bf3b33b59f05622966712748f3cc85388495a062a2242ec4ee6bd83</cites><orcidid>0000-0002-3842-3186 ; 0000-0002-1529-0165 ; 0000-0001-8471-231X ; 0000-0002-7858-4195 ; 0000-0001-9246-9380 ; 0000-0003-4289-4527 ; 0000-0002-0717-2388 ; 0000-0003-4968-5138 ; 0000-0002-7556-1262 ; 0000-0002-4063-533X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3064264299/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3064264299?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,24149,25752,27923,27924,37011,37012,44589,53790,53792,74897</link.rule.ids></links><search><creatorcontrib>Mendes, Ana Karolina Torres</creatorcontrib><creatorcontrib>Ribeiro, Marizélia Rodrigues Costa</creatorcontrib><creatorcontrib>Lamy-Filho, Fernando</creatorcontrib><creatorcontrib>Amaral, Gláucio Andrade</creatorcontrib><creatorcontrib>Borges, Marcella Costa Ribeiro</creatorcontrib><creatorcontrib>Costa, Luciana Cavalcante</creatorcontrib><creatorcontrib>Cavalcante, Tamires Barradas</creatorcontrib><creatorcontrib>Batista, Rosângela Fernandes Lucena</creatorcontrib><creatorcontrib>Sousa, Patrícia da Silva</creatorcontrib><creatorcontrib>Silva, Antônio Augusto Moura da</creatorcontrib><title>Congenital Zika syndrome: association between the gestational trimester of maternal infection, severity of brain computed tomography findings and microcephaly at birth</title><title>Revista do Instituto de Medicina Tropical de São Paulo</title><addtitle>Rev. Inst. Med. trop. S. Paulo</addtitle><description>This study analyzed possible associations between the trimester of maternal Zika virus infection (ZIKV) in pregnancy, severity of brain computed tomography (CT) findings and the presence of microcephaly at birth in children with Congenital Zika Syndrome (CZS). It was an analytical study in a cohort of children with CZS. Symptoms of maternal infection were dichotomized into the 1
st
trimester of pregnancy and other trimesters. Head circumference (HC) at birth was used to calculate the z-score. Mild microcephaly was defined as HC between 2 and ≥3 standard deviations (SD) below the mean for each gestational age and sex, and severe microcephaly when HC <3 SD below average. Brain CT images were evaluated by two radiologists and classified, according to the severity, into mild, moderate and severe. Fisher’s exact, Mann-Whitney and Kruskal-Wallis tests were used to verify the associations between variables. In 108 children, maternal infection in the 1
st
trimester of pregnancy was associated with more severe brain CT abnormalities (p=0.038), greater severity of microcephaly at birth (p=0.013) and lower HC z-scores at birth (p=0.021). The severity of brain CT lesions was also associated with lower HC z-scores at birth (p<0.001). Maternal ZIKV infection during the first trimester of pregnancy proved to be an important risk factor for a more severe spectrum of CZS, as it is associated with more severe brain CT abnormalities and, consequently, with lower HC z-scores at birth.</description><subject>Brain computed tomography</subject><subject>Congenital abnormalities</subject><subject>Microcephaly</subject><subject>Original</subject><subject>TROPICAL MEDICINE</subject><subject>Zika virus</subject><subject>Zika virus infection</subject><issn>1678-9946</issn><issn>0036-4665</issn><issn>1678-9946</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdUk2P0zAQjRCIXRZ-ARdLXDjQxbEdO-aAtKr4WGklDsCFizVxJq1LYhfbXdRfxN_EaVcVxbL88ebN83hmquplTa_rRtO3qZaqXWgtJKOMlqWRj6rLE_j4n_NF9SylDaVUUy2fVhectUJoqi6rP8vgV-hdhpH8cD-BpL3vY5jwHYGUgnWQXfCkw_wb0ZO8RrLClA9occnRTeWKkYSBTFAOM-r8gHZmvCEJ7zG6vJ_tXQTniQ3TdpexJzlMYRVhu96Twfne-VUi4HsyORuDxe0axj2BTDoX8_p59WSAMeGLh_2q-v7xw7fl58Xdl0-3y5u7hW3aOi-0QoDGombdwDvOu0YPJS-MaSlVzZRoB25t2_C2FbqBkjVgTDC0AlF2fcuvqtujbh9gY7blexD3JoAzByDElYGYnR3RWMFrGKjqEXuhYNCqvIpWda0a2rpmRev6qJWswzGYTdjN6UnmK6VcGiFlM1eujJpSxmRxeH902O66CXuLPkcYz6I4t3i3Nqtwb5QQinFRBF4_CMTwa1cKYyaXLI4jeAy7ZJjgimupRV2or_6jnsLjVApWptaFxY-sUpKUIg6nYGpq5i40hy40Z13I_wIbf9Bf</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Mendes, Ana Karolina Torres</creator><creator>Ribeiro, Marizélia Rodrigues Costa</creator><creator>Lamy-Filho, Fernando</creator><creator>Amaral, Gláucio Andrade</creator><creator>Borges, Marcella Costa Ribeiro</creator><creator>Costa, Luciana Cavalcante</creator><creator>Cavalcante, Tamires Barradas</creator><creator>Batista, Rosângela Fernandes Lucena</creator><creator>Sousa, Patrícia da Silva</creator><creator>Silva, Antônio Augusto Moura da</creator><general>Instituto de Medicina Tropical de Sao Paulo</general><general>Instituto de Medicina Tropical</general><general>Instituto de Medicina Tropical de São Paulo</general><general>Universidade de São Paulo (USP)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CLZPN</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope><scope>GPN</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3842-3186</orcidid><orcidid>https://orcid.org/0000-0002-1529-0165</orcidid><orcidid>https://orcid.org/0000-0001-8471-231X</orcidid><orcidid>https://orcid.org/0000-0002-7858-4195</orcidid><orcidid>https://orcid.org/0000-0001-9246-9380</orcidid><orcidid>https://orcid.org/0000-0003-4289-4527</orcidid><orcidid>https://orcid.org/0000-0002-0717-2388</orcidid><orcidid>https://orcid.org/0000-0003-4968-5138</orcidid><orcidid>https://orcid.org/0000-0002-7556-1262</orcidid><orcidid>https://orcid.org/0000-0002-4063-533X</orcidid></search><sort><creationdate>20200101</creationdate><title>Congenital Zika syndrome: association between the gestational trimester of maternal infection, severity of brain computed tomography findings and microcephaly at birth</title><author>Mendes, Ana Karolina Torres ; 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Inst. Med. trop. S. Paulo</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>62</volume><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>1678-9946</issn><issn>0036-4665</issn><eissn>1678-9946</eissn><abstract>This study analyzed possible associations between the trimester of maternal Zika virus infection (ZIKV) in pregnancy, severity of brain computed tomography (CT) findings and the presence of microcephaly at birth in children with Congenital Zika Syndrome (CZS). It was an analytical study in a cohort of children with CZS. Symptoms of maternal infection were dichotomized into the 1
st
trimester of pregnancy and other trimesters. Head circumference (HC) at birth was used to calculate the z-score. Mild microcephaly was defined as HC between 2 and ≥3 standard deviations (SD) below the mean for each gestational age and sex, and severe microcephaly when HC <3 SD below average. Brain CT images were evaluated by two radiologists and classified, according to the severity, into mild, moderate and severe. Fisher’s exact, Mann-Whitney and Kruskal-Wallis tests were used to verify the associations between variables. In 108 children, maternal infection in the 1
st
trimester of pregnancy was associated with more severe brain CT abnormalities (p=0.038), greater severity of microcephaly at birth (p=0.013) and lower HC z-scores at birth (p=0.021). The severity of brain CT lesions was also associated with lower HC z-scores at birth (p<0.001). Maternal ZIKV infection during the first trimester of pregnancy proved to be an important risk factor for a more severe spectrum of CZS, as it is associated with more severe brain CT abnormalities and, consequently, with lower HC z-scores at birth.</abstract><cop>São Paulo</cop><pub>Instituto de Medicina Tropical de Sao Paulo</pub><pmid>32844907</pmid><doi>10.1590/s1678-9946202062056</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3842-3186</orcidid><orcidid>https://orcid.org/0000-0002-1529-0165</orcidid><orcidid>https://orcid.org/0000-0001-8471-231X</orcidid><orcidid>https://orcid.org/0000-0002-7858-4195</orcidid><orcidid>https://orcid.org/0000-0001-9246-9380</orcidid><orcidid>https://orcid.org/0000-0003-4289-4527</orcidid><orcidid>https://orcid.org/0000-0002-0717-2388</orcidid><orcidid>https://orcid.org/0000-0003-4968-5138</orcidid><orcidid>https://orcid.org/0000-0002-7556-1262</orcidid><orcidid>https://orcid.org/0000-0002-4063-533X</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Brain computed tomography Congenital abnormalities Microcephaly Original TROPICAL MEDICINE Zika virus Zika virus infection |
title | Congenital Zika syndrome: association between the gestational trimester of maternal infection, severity of brain computed tomography findings and microcephaly at birth |
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