Gross Motor Function in Children with Congenital Zika Syndrome
Background Little information on gross motor function of congenital Zika syndrome (CZS) children is available.
Objectives To evaluate gross motor function in CZS children aged up to 3 years, and its associated factors and changes in a minimum interval of 6 months.
Methods One hundred children with CZS and cerebral palsy (36 with confirmed and 64 with presumed CZS) were evaluated with the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM-88/GMFM-66). Forty-six were reevaluated. Wilcoxon tests, Wilcoxon tests for paired samples, percentile scores, and score changes were performed.
Results Clinical and socioeconomic characteristics (except maternal age), GMFM scores and GMFCS classification of confirmed and probable cases, which were analyzed together, were similar. The mean age was 25.6 months (±5.5); the median GMFM-88 score was 8.0 (5.4–10.8); and the median GMFM-66 score was 20.5 (14.8–23.1); 89% were classified as GMFCS level V. Low economic class, microcephaly at birth, epilepsy, and brain parenchymal volume loss were associated with low GMFM-66 scores. The median GMFM-66 percentile score was 40 (20–55). On the second assessment, the GMFM-66 scores in two GMFCS level I children and one GMFCS level IV child improved significantly. In one GMFCS level III child, one GMFCS level IV child, and the group of GMFCS level V children, no significant changes were observed.
Conclusions Almost all CZS children had severe cerebral palsy; in the third year of life, most presented no improvement in gross motor function and were likely approaching their maximal gross motor function potential.
Table of Contents Summary
Gross motor function and its associated factors of 100 children with confirmed or presumed CZS were evaluated. Forty-six children were reevaluated in a minimum interval of 6 months.
Ms. Eliana Harumi Morioka Takahasi conceived and designed the study, collected the data on motor function, performed the analysis, drafted the initial manuscript. Professor Maria Teresa Seabra Soares de Britto e Alves, Professor Marizélia Rodrigues Costa Ribeiro and Professor Vanda Maria Ferreira Simões conceived and designed the study, revised the work critically for important intellectual content, and approved the final version to be submitted. Ms. Valéria Ferreira Pereira Souza collected the data on motor function, revised the work critically for important intellectual content, and approved the final version to be submitted. Gláucio Andrade Amaral and Marcella Costa Ribeiro Borges collected the data on neuroimaging findings, revised the work critically for important intellectual content, and approved the final version to be submitted. Ms. Lillian Nunes Gomes and Professor Ricardo Khouri collected the data on the laboratory confirmation of Zika virus infection, revised the work critically for important intellectual content, and approved the final version to be submitted. Dr. Patricia da Silva Sousa collected the data on clinical diagnosis and neurological symptoms of the sample, contributed to analysis and interpretation of data, revised the work critically for important intellectual content, and approved the final version to be submitted. Professor Antonio Augusto Moura da Silva is the main researcher of the project “Congenital Zika syndrome,” conceived and designed the study, coordinated and supervised data collection, contributed to analysis and interpretation of data, revised the work critically for important intellectual content, and approved the final version to be submitted. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
Received: 04 May 2020
Accepted: 31 August 2020
27 October 2020 (online)
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