Nutritional profile of newborns with microcephaly and factors associated with worse outcomes

Abstract

OBJECTIVE:To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life.METHODS:This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student’s t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with p<0.05 indicating significance.RESULTS:During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (p<0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization.CONCLUSION:The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status.

Time to Evaluate the Clinical Repercussions of Zika Virus Vertical Transmission? A Systematic Review

“…All papers that evaluated gastrointestinal manifestations reported dysphagia ( 38 , 46 , 48 , 61 ). Regarding the nutritional status of children exposed to antenatal ZIKV, nine papers found anthropometric alterations such as low birth weight and growth retardation ( 14 , 20 , 21 , 28 , 29 , 33 , 48 , 50 , 63 , 66 ) and one study observed endocrine dysfunctions in children with Zika-related microcephaly ( 75 ).…”

Feeding modifications and additional primary caregiver support for infants exposed to Zika virus or diagnosed with congenital Zika syndrome: a rapid review of the evidence

“…As shown in Table 1, several of the observational studies described growth outcome differences among children exposed to ZIKV or diagnosed with CZVS compared to children unexposed to ZIKV. Weight, length, head circumference, arm circumferences and fat‐free mass were lower among children exposed to ZIKV or diagnosed with CZVS at different ages [33–35], including infants hospitalised during the first days of life [36]. Weight status was also affected by type of feeding, with lower weight among those fed orally as compared to those with nasogastric or orogastric tube feeding [36] or those fed infant formula compared to breast milk (breastfeeding, expressed milk or milk bank) [36].…”

“…Many of the studies also described the primary caregivers of infants exposed to ZIKV or diagnosed with CZVS. Most primary caregivers were mothers less than 30 years of age who did not have a partner and who lived in low‐income households [34, 36, 38, 40]. In one of the studies, over 60% of mothers had not received prenatal care before 6 months of pregnancy [36].…”

“…Most primary caregivers were mothers less than 30 years of age who did not have a partner and who lived in low‐income households [34, 36, 38, 40]. In one of the studies, over 60% of mothers had not received prenatal care before 6 months of pregnancy [36]. Higher education was related to better weight status in one of the studies [36].…”

“…In one of the studies, over 60% of mothers had not received prenatal care before 6 months of pregnancy [36]. Higher education was related to better weight status in one of the studies [36]. Caretakers of children with CZVS had very demanding daily routines of household chores, care and oversight of siblings without CZVS, care of the child with CZVS and attending child rehabilitation/stimulation centres [38].…”