Table 3.
Functional outcomes* at approximately 24 months of age, among children meeting anthropometric and/or laboratory criteria for follow-up of congenital Zika virus infection, Paraíba, Brazil, 2017
| Outcome | Anthropometric/laboratory criteria† of congenital Zika infection | ||
|---|---|---|---|
| Microcephaly/disproportionate with laboratory criteria§ | Disproportionate without laboratory criteria | Laboratory criteria only | |
| N = 43, N (%) | N = 20,‡ N (%) | N = 57, N (%) | |
| Severe motor impairment | 26 (61) | 0 (0) | 0 (0) |
| Cerebral palsy | 25 (58) | 0 (0) | 0 (0) |
| Impaired response to auditory stimuli | 23 (54) | 0 (0) | 0 (0) |
| Impaired response to visual stimuli—HINE | 21 (49) | 0 (0) | 0 (0) |
| Suboptimal score on any HINE domain | 26 (61) | 0 (0) | 1 (2) |
| Developmental delay classification‖ (overall) | |||
| Severe | 27 (63) | 2 (10) | 3 (5) |
| Mild to moderate | 7 (16) | 9 (45) | 26 (46) |
| None | 9 (21) | 9 (45) | 28 (49) |
| Vision | |||
| Retinal abnormalities | 7 (16) | 0 (0) | 0 (0) |
| Abnormal fixation and following | 16 (37) | 0 (0) | 0 (0) |
| Positive seizure screen | 18 (43) | 0 (0) | 2 (4) |
| Missing | 1 | 0 | 1 |
HC = head circumference; HINE = Hammersmith Infant Neurological Examination.
Children were evaluated for functional outcomes, including developmental delay (using the Ages and Stages v.3 [ASQ-3] questionnaires) and neurologic outcomes (using the HINE) at approximately 24 months of age.
Anthropometric criteria: 1) microcephaly (HC ≤ 3rd percentile for gestational age and sex) or 2) HC > 3rd percentile for gestational age and sex and disproportionate (HC:body length ≤ 0.65); laboratory criteria: nonnegative Zika neutralizing antibody test results.
Three children had missing HC at birth and disproportionate HC:length when measured at 1–7 months of age.
In this group, 23 children had microcephaly and were disproportionate (had HC:length ratio ≤ 0.65); 4 children had microcephaly with HC:length ratio > 0.65, and 16 children were disproportionate but did not have microcephaly.
Severe: z-scores below −2 SD from the mean on at least two ASQ-3 domains, mild to moderate: z-scores below −2 SD on one domain or from −1 SD to −2 SD on at least one domain, none: z-scores (all domains) above −1 SD from the mean.