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Prevalence and diagnostic accuracy of microcephaly in a pediatric cohort in Brazil: A retrospective cross-sectional study.

Abstract：

OBJECTIVE:We sought to describe the prevalence of microcephaly and to compare the different cutoff points established by the Brazilian Ministry of Health (MoH) at various times during a Zika virus epidemic. As a secondary aim, we investigated the possible etiology of the microcephaly. METHOD:This retrospective study utilized newborn participants in the Zika Cohort Study Jundiaí (ZCJ). Newborns from the ZCJ with an accurate gestational age determination and complete anthropometric data were analyzed, and microcephaly was diagnosed according to the INTERGROWTH-21st curve (IG). At delivery, fluids were tested for specific antibodies and for viruses. Brain images were evaluated for microcephaly. Receiver Operating Characteristic (ROC) curves were plotted to define the accuracy of different cutoff points for microcephaly diagnosis. RESULTS:Of 462 eligible newborns, 19 (4.1%) were positive for microcephaly. Cutoff points corresponding to the curves of the World Health Organization yielded the best sensitivity and specificity. Three of the microcephaly cases (15.8%) were positive for Zika virus infections; nine (47.4%) had intrauterine growth restriction (IUGR); one had intrauterine growth restriction and was exposed to Zika virus; three had a genetic syndrome (15.8%); and three had causes that had not been determined (15.8%). CONCLUSIONS:Microcephaly prevalence was 4.1% in this study. Cutoff values determined by the World Health Organization had the highest sensitivity and specificity in relation to the standard IG curve. The main reason for microcephaly was intrauterine growth restriction. All possible causes of microcephaly must be investigated to allow the best development of an affected baby.

journal_name

J Pediatr (Rio J)

journal_title

Jornal de pediatria

authors

Bertozzi APAP,Gazeta RE,Fajardo TCG,Moron AF,Soriano-Arandes A,Alarcon A,Garcia-Alix A,Silva ABD,Filho NF,Sarmento SGP,Witkin SS,Passos SD

doi

10.1016/j.jped.2020.08.010

subject

Has Abstract

pub_date

2020-10-18 00:00:00

eissn

0021-7557

issn

1678-4782

pii

S0021-7557(20)30214-X

pub_type

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Prevalence and diagnostic accuracy of microcephaly in a pediatric cohort in Brazil: A retrospective cross-sectional study.