Achados gestacionais em mulheres infectadas por Zika vírus durante a gravidez no Mato Grosso do Sul, Brasil

Abstract

In the year 2015 a temporal relationship between the increase of microcephaly reports and the Zika Virus (ZIKV) outbreak was observed, becoming a major public health problem in Brazil. Changes are observed not only in the central nervous system, but in several other systems such as cardiac, renal, ophthalmologic, osteoarticular and cognitive alterations, giving rise to what we know as Zika Congenital Syndrome (SCZ). In November 2015 the Ministry of Health of Brazil declared a State of Emergency in Public Health of National Importance (ESPIN) and from then on several incentives for research were carried out and changes in health policies regarding ZIKV infection became part of the country's notifiable diseases in February 2016. Only in April 2016, after isolation of viral RNA in a sample of amniotic fluid from pregnant women with alteration in their fetuses after ZIKV infection, was the association with congenital abnormalities accepted. The objective of this study was to identify the variables associated with congenital abnormalities in newborns of pregnant women with ZIKV infection reported in the Notification of Injury Information System in Mato Grosso do Sul in the years 2015 and 2016. This study included 117 pairs of mothers and children (all mothers had laboratory confirmation of qRT-PCR of ZIKV infection during pregnancy) and 120 gestational results. Of these, 23 (19.16%) were considered clinical manifestations of CZS and 97 (80.83%) without CZS. The prevalence of congenital anomalies related to ZIKV was 2.69 cases per 10,000 live births in the period. Exanthema was the symptom observed in 92.5% of the mothers of this study. STORCH prenatal laboratory tests were performed in 13 (53.52%) of the mothers of the CZS group and only one positive serology for Cytomegalovirus was detected. Only 13 (56.52%) of children with CZS were tested for qRT-PCR for ZIKV infection at birth, five (38%) were positive. A case fatality rate of 6 (5%) was found in this study. Among the 23 children classified with CZS, 13 (56.52%) of them had microcephaly. About 14 children (60.87%) had some brain alteration and 11 (47.83%) had altered motor development. Among the other neurological alterations, epilepsy / spasms / seizures 9 (39.13%) and spasticity 5 (21.74%) were the most prevalent. Cardiac changes were detected in two of the seven children who underwent an echocardiogram. This study highlights the congenital alterations of ZIKV infection during pregnancy in an epidemic outbreak in the state of Mato Grosso do Sul in a region of western Brazil, demonstrating that the alterations found in other studies are similar to this research.