Devenir neurodéveloppemental des enfants présentant une microcéphalie isolée ou associée à une malformation cérébrale dans un contexte d’infection maternelle au Zika pendant la grossesse

Abstract : Introduction. Zika epidemic outbreak was observed in Guadeloupe and the French West Indies in 2016. Microcephaly and brain abnormalities was noticed in fetuses exposed to the virus in utero. The main objective of this study was to determine the medium-term neurodevelopmental outcome of children born in a context of maternal Zika infection during pregnancy with microcephaly or cerebral abnormality. We also described weight and height growth and neurosensory associated comorbidities. Material and method. It was an observational, descriptive, prospective, monocentric case study conducted at Pointe-à-Pitre / Abymes University Hospital Center in Guadeloupe from November 2016 through August 2018. We conducted a standardized survey entitled "Child Development Inventory" to obtain development quotient for each child included. Results. We followed 11 children for an average of 16.8 months. The average age at the time of the assessment was 18.9 months. Isolated microcephaly cases had normal neurological examination and neuro-psychomotor development with an average development quotient of 122.25%. In contrast, children with associated cerebral malformations had predominantly spastic quadriparesis in the upper limbs with a very high risk of delay and developmental quotient less than 63.6%. Conclusion. According to the literature data, children with congenital Zika syndrome had an overall developmental delay in the medium term. They also had a height and weight stunting without hormonal or carential etiology identified. Unlike the other studies, we did not find neurosensory deficit. One of the major challenges will be early identification of longer-term neurological disorders in children exposed in utero to Zika and asymptomatic at birth. This involves setting up a dedicated monitoring network associating the « Centres d’Action Médico-Sociale Précoce » and the liberals pediatricians.
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Master Thesis
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Anne-Sophie Beltoise. Devenir neurodéveloppemental des enfants présentant une microcéphalie isolée ou associée à une malformation cérébrale dans un contexte d’infection maternelle au Zika pendant la grossesse. Pédiatrie. 2018. ⟨dumas-02004268⟩

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