A new insight into the definition of microcephaly in Zika congenital syndrome era

Gonçalves, Fabiana Cristina Lima da Silva Pastich; Lima, Marília de Carvalho; Ximenes, Ricardo Arraes de Alencar; Miranda-Filho, Demócrito de Barros; Martelli, Celina Maria Turchi; Rodrigues, Laura C.; Souza, Wayner Vieira de; Lira, Pedro Israel Cabral de; Eickmann, Sophie Helena; Araújo, Thália Velho Barreto de

doi:10.1590/0102-311x00228520

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…S6A). We questioned whether this reduction in cortical thickness was disproportionate to the fetal body mass to give insights into the potential of these fetuses exhibiting disproportionate microcephaly, which is observed in some human fetuses with severe CZS ( 37 , 38 ). For the ZIKV-infected DENV-immune group, the cortex was disproportionately reduced relative to the body mass compared with the uninfected healthy controls (Fig.…”

Section: Resultsmentioning

confidence: 99%

Exacerbated Zika virus–induced neuropathology and microcephaly in fetuses of dengue-immune nonhuman primates

Saron,

Shanmugam,

Tung

et al. 2023

Sci. Transl. Med.

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Zika virus (ZIKV) is a mosquito-borne flavivirus that can vertically transmit from mother to fetus, potentially causing congenital defects, including microcephaly. It is not fully understood why some fetuses experience severe complications after in utero exposure to ZIKV, whereas others do not. Given the antigenic similarity between ZIKV and the closely related virus dengue (DENV) and the potential of DENV-specific antibodies to enhance ZIKV disease severity in mice, we questioned whether maternal DENV immunity could influence fetal outcomes in a nonhuman primate model of ZIKV vertical transmission. We found significantly increased severity of congenital Zika syndrome (CZS) in fetuses of DENV-immune cynomolgus macaques infected with ZIKV in early pregnancy compared with naïve controls, which occurred despite no effect on maternal ZIKV infection or antibody responses. Ultrasound measurements of head circumference and biparietal diameter measurements taken sequentially throughout pregnancy demonstrated CZS in fetuses of DENV-immune pregnant macaques. Furthermore, severe CZS enhanced by DENV immunity was typified by reduced cortical thickness and increased frequency of neuronal death, hemorrhaging, cellular infiltrations, calcifications, and lissencephaly in fetal brains. This study shows that maternal immunity to DENV can worsen ZIKV neurological outcomes in fetal primates, and it provides an animal model of vertical transmission closely approximating human developmental timelines that could be used to investigate severe ZIKV disease outcomes and interventions in fetuses.

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Section: Resultsmentioning

confidence: 99%

Exacerbated Zika virus–induced neuropathology and microcephaly in fetuses of dengue-immune nonhuman primates

Saron,

Shanmugam,

Tung

et al. 2023

Sci. Transl. Med.

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“…Microcephaly was defined when the head circumference was less than two standard deviations below the mean for gestational age and sex. Normocephaly was defined when the head circumference was above or equal to two standard deviations above the mean [ 2 , 15 ]. The presence or absence of spastic tetraparesis and seizures was confirmed by a neurologist who was responsible for monitoring the children.…”

Section: Methodsmentioning

confidence: 99%

Factors Associated with Behavioral Disorders in Children with Congenital Zika Syndrome and Their Families—A Cross-Sectional Study

Arrais

Maia

Rodrigues

et al. 2022

IJERPH

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The Zika virus was responsible for an outbreak between 2015 and 2016 in Brazil: an alarming public health problem of international relevance. The Congenital Zika Syndrome (CZS) is often associated with manifestations that are responsible for cognitive and motor development delays and behavioral disorders. Thus, we aimed to characterize the clinical-epidemiological and familial context of those children and to identify factors associated with the risk of behavioral disorders using the Survey of Well-Being of Young Children questionnaire (SWYC). In total, 52 children diagnosed with CZS were evaluated. Logistic regressions were employed to assess predictive variables for behavioral alteration. Eighteen (35%) of the children presented a risk of behavioral alteration. Children born normocephalic were 36-fold more likely to present behavioral alteration (95% CI: 3.82 to 337.92, p = 0.002). Children with hearing and visual impairments showed reduced risks. In total, 35% percent of families reported food insecurity and 21% were at risk for maternal depression. Our findings suggest better social interactions and conditions to externalize reactions for children with CZS born normocephalic. The continuous assessment of these children and families may identify conditions associated with behavioral alteration and psychosocial vulnerabilities that help in decision-making, therefore optimizing patient–family interactions.

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A new insight into the definition of microcephaly in Zika congenital syndrome era

Cited by 2 publications

References 22 publications

Exacerbated Zika virus–induced neuropathology and microcephaly in fetuses of dengue-immune nonhuman primates

Exacerbated Zika virus–induced neuropathology and microcephaly in fetuses of dengue-immune nonhuman primates

Factors Associated with Behavioral Disorders in Children with Congenital Zika Syndrome and Their Families—A Cross-Sectional Study

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