Congenital Zika Infection and the Risk of Neurodevelopmental, Neurological, and Urinary Track Disorders in Early Childhood. A Systematic Review

Antoniou, Evangelia; Orovou, Eirini; Andronikidi, Paraskevi Eva; Orovas, Christos; Rigas, Nikolaos; Palaska, Ermioni; Sarella, Angeliki; Iatrakis, Georgios; Voyiatzaki, Chrysa

doi:10.3390/v13081671

Cited by 5 publications

(5 citation statements)

References 41 publications

(70 reference statements)

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“…8 Two recently published systematic reviews confirmed the importance of continuous monitoring of these children and their growth to better understand and control postnatal complications. 9,10 Recognising that ZIKV affects many structures of the central nervous system, including those that control physiological functioning of the bladder and urinary sphincter, supports the hypothesis that intrauterine ZIKV infection can affect urinary function. [11][12][13][14] A study conducted in Rio de Janeiro, including children with confirmed CZS, was the first to describe a urodynamic pattern suggestive of neurological lower urinary tract dysfunction (NLUTD), with reduced bladder capacity and higher vesical pressure during bladder filling in this population.…”

Section: Introductionmentioning

confidence: 96%

“…Currently, 7 years after its first publication, much has been discussed about brain patterns, 2 neurological conditions, 6 growth, 7 and motor, cognitive, and sensory impairment 8 . Two recently published systematic reviews confirmed the importance of continuous monitoring of these children and their growth to better understand and control postnatal complications 9, 10 …”

Section: Introductionmentioning

confidence: 99%

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Urological outcomes in children with congenital Zika syndrome: The experience of a cohort in Campina Grande, Brazil

Ferreira

Pinheiro

Melo

et al. 2022

Tropical Med Int Health

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Objective To describe the urological outcomes in children with congenital Zika syndrome (CZS) and investigate the relationship between clinical and urological findings in this population. Methods This cross‐sectional study involved children with CZS followed up by a referral centre for children with microcephaly in the state of Paraiba in northeast Brazil. The urological evaluation included clinical history, urine culture results, ultrasonography of the urinary tract, and urodynamic evaluation, following the protocol proposed by Costa Monteiro et al. (2017). Descriptive statistical analysis was performed in addition to association and correlation tests, considering clinical and urodynamic variables. Results Among the 88 children with CZS (35.5 ± 5.5 months), 97.7% had microcephaly, and 51% presented urinary tract infection (UTI) confirmed with clinical history and lab tests. The number of confirmed UTI episodes varied from one to 14 per child. The urodynamic evaluation confirmed the presence of an overactive bladder in 78 children and incomplete voiding in 50. Urodynamic findings were associated with the number of confirmed UTI episodes, child's sex, and actual weight, in addition to the use of anticonvulsant and myorelaxant drugs. Conclusions UTIs were confirmed in most children. Other urological outcomes observed were overactive bladder and low bladder capacity, which were associated with the number of confirmed UTI episodes, use of anticonvulsants and myorelaxants, and the child's sex and weight. These are treatable conditions, and it is paramount that paediatricians, neonatologists, and infectious disease specialists are aware of them to make clinical decisions and help reduce the risk of renal damage and other morbidities.

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Urological outcomes in children with congenital Zika syndrome: The experience of a cohort in Campina Grande, Brazil

Ferreira

Pinheiro

Melo

et al. 2022

Tropical Med Int Health

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“…On the other hand, SCZ is a new syndrome, so its characterization is important and for which neurodevelopmental assessments are a valuable tool. In previous reports of infants exposed to ZIKV during pregnancy, it was observed that the risk of developing neurodevelopmental disorders may be related to the presence of microcephaly [ 22 , 47 ]. The risk of neurodevelopmental delay can range from 13.8% to 20.2% in normocephalic infants, while this percentage increases from 99.1% to 100% when infants develop severe microcephaly or from 65% to 70% in cases of moderate microcephaly [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…The high incidence of cases in pregnant women is important due to the fact that ZIKV infection during pregnancy has been associated with the development of anomalies in newborns [ 11 ], such as morphological–cranial [ 12 ], cerebral [ 13 , 14 , 15 ], ophthalmic [ 16 ], neurological [ 17 ], and joint contractures [ 18 , 19 ], which have been grouped into a new syndrome called Congenital Zika Syndrome (CZS) [ 11 , 20 ]. Some anomalies caused by intrauterine ZIKV infection can manifest postnatally, such as postnatal microcephaly [ 21 ] and neurodevelopmental disorders, that could affect cognitive, motor, and social functions [ 22 ], even in healthy infants [ 23 ]. Neurodevelopmental assessment in infants exposed to ZIKV during pregnancy is of great importance because it allows the characterization of the effects of gestational ZIKV infection at birth and in the long term, due to the possible impairment of cognitive, motor, and social skills in infants.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Anomalies and Neurodevelopment in Children Exposed to ZIKV during Pregnancy

et al. 2022

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Zika virus (ZIKV) infection in pregnancy is associated with birth and developmental alterations in infants. In this study, clinical records of 47 infants whose mothers had Zika during pregnancy or clinical manifestations compatible with Zika were reviewed. A description of the infants’ anomalies was established, and a neurodevelopmental assessment was performed on 18 infants, using the Evaluation of Infant Development (EDI for its initialism in Spanish) and DDST-II (Denver Developmental Screening Test II) tests. From his sample, 74.5% of the infants evaluated had major anomalies and 51.9% had minor anomalies. The incidence of major anomalies, related to trimester of pregnancy, was 84.2% for the first trimester, 77.8% for the second trimester, and 37.5% in the third trimester. A similar trend was observed in the frequency of infants without anomalies and was less evident in the incidence of minor anomalies (p = 0.016). Through neurodevelopmental assessments, EDI identified 27.8% of infants as having normal development, while 55.5% of affected infants had developmental delay, and 16.7% were at risk for developmental delay. The DDSST-II showed that 77.7% infants had delay in the gross motor and language area, 88.8% in the fine-adaptative motor area, and 72.2% in the personal–social area. In this work, children of mothers with ZIKV infection during pregnancy may have major or minor anomalies regardless of the trimester of pregnancy in which the infection occurred. The neurodevelopmental assessment shows that ZIKV can cause a developmental delay in infants with the fine-adaptative motor area being the most affected.

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“…These findings were characterized as Neurogenic Bladder (NB) with risk for the upper urinary tract. In a recent systematic review, the first studies addressing to LUT function presented discordant findings and methodological criticisms [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Zika-Related Microcephaly and Its Repercussions for the Urinary Tract: Clinical, Urodynamic, Scintigraphic and Radiological Aspects

Vasconcelos

Ximenes

Calado

et al. 2022

Viruses

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Aims: Describing the urodynamic parameters of children aged 3 to 5 years with microcephaly related to congenital Zika syndrome and verifying the association with clinical, imaging and neurological characteristics. Methods: From October 2018 to March 2020, children with Zika-related microcephaly underwent urological, ultrasonographic and urodynamic evaluation. In selected cases, complementary exams such as urethrocystography and scintigraphy were performed. The children also underwent a complete neurological evaluation. To compare frequency between groups, we used Pearson’s chi-squared test or Fisher’s exact test. Results: This study evaluated 40 children, of whom 85% were 4 years old, and all had abnormalities on the urodynamic study, with low bladder capacity (92.5%) and detrusor overactivity (77.5%) as the most frequent findings. Only three children had ultrasound abnormalities, but no child had cystographic or scintigraphic abnormalities, and the postvoid residual volume was normal in 80% of cases. In spite of a frequency of 67.5% of intestinal constipation, there was no record of febrile urinary tract infection after the first year of life. All children presented severe microcephaly and at least one neurological abnormality in addition to microcephaly. The homogeneity of the children in relation to microcephaly severity and neurological abnormalities limited the study of the association with the urodynamic parameters. Conclusions: Urodynamic abnormalities in children aged 3 to 5 years with Zika-related microcephaly do not seem to characterize a neurogenic bladder with immediate risks for the upper urinary tract. The satisfactory bladder emptying suggests that the voiding pattern is reflex.

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Congenital Zika Infection and the Risk of Neurodevelopmental, Neurological, and Urinary Track Disorders in Early Childhood. A Systematic Review

Cited by 5 publications

References 41 publications

Urological outcomes in children with congenital Zika syndrome: The experience of a cohort in Campina Grande, Brazil

Urological outcomes in children with congenital Zika syndrome: The experience of a cohort in Campina Grande, Brazil

Evaluation of Anomalies and Neurodevelopment in Children Exposed to ZIKV during Pregnancy

Zika-Related Microcephaly and Its Repercussions for the Urinary Tract: Clinical, Urodynamic, Scintigraphic and Radiological Aspects

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