Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil

Pool, Kara-Lee; Adachi, Kristina; Karnezis, Stellios; Salamon, Noriko; Romero, Tahmineh; Nielsen-Saines, Karin; Pone, Sheila Moura; Boechat, Marcia Cristina Bastos; Aibe, Mitsue Senra; Silva, Tallita Gomes da; Ribeiro, Carla Trevisan Martins; Boechat, M. Ines; Brasil, Patrícia; Zin, Andrea; Tsui, Irena; Gaw, Stephanie L.; Daltro, Pedro; Ribeiro, Bianca Guedes; Fazecas, Tatiana; Cruz, L. Celso Hygino da; Nogueira, Renata; Vasconcelos, Zilton Farias Meira de; Pereira, Jose Paulo; Salles, Tania Regina Dias Saad; Barbosa, Claudia Neves; Chen, Weiqiang; Foo, Suan-Sin; Jung, Jae; Moreira, Maria Elisabeth Lopes; Pone, Marcos Vinicius da Silva

Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil

Detalhes bibliográficos
Autor(a) principal:	Pool, Kara-Lee
Data de Publicação:	2019
Outros Autores:	Adachi, Kristina, Karnezis, Stellios, Salamon, Noriko, Romero, Tahmineh, Nielsen-Saines, Karin, Pone, Sheila Moura, Boechat, Marcia Cristina Bastos, Aibe, Mitsue Senra, Silva, Tallita Gomes da, Ribeiro, Carla Trevisan Martins, Boechat, M. Ines, Brasil, Patrícia, Zin, Andrea, Tsui, Irena, Gaw, Stephanie L., Daltro, Pedro, Ribeiro, Bianca Guedes, Fazecas, Tatiana, Cruz, L. Celso Hygino da, Nogueira, Renata, Vasconcelos, Zilton Farias Meira de, Pereira, Jose Paulo, Salles, Tania Regina Dias Saad, Barbosa, Claudia Neves, Chen, Weiqiang, Foo, Suan-Sin, Jung, Jae, Moreira, Maria Elisabeth Lopes, Pone, Marcos Vinicius da Silva
Tipo de documento:	Artigo
Idioma:	eng
Título da fonte:	Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo:	https://www.arca.fiocruz.br/handle/icict/35527
Resumo:	Patrícia Brasil. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento. David Geffen School of Medicine, University of California, Los Angeles (Pool, Adachi, Karnezis, Salamon, Romero, Nielsen-Saines, M. I. Boechat, Tsui); Fundação Oswaldo Cruz, Rio de Janeiro, Brazil (S. Pone, M. Boechat, Aibe, Gomes da Silva, C. T. M. Ribeiro, Brasil, Zin, Vasconcelos, Pereira, Saad Salles, Barbosa, Moreira, M. Pone); University of California San Francisco School of Medicine (Gaw); Clinica de Diagnostico por Imagem CDPI, Rio de Janeiro, Brazil (Daltro, B. G. Ribeiro, Fazecas, Hygino da Cruz, Nogueira); University of Southern California School of Medicine, Los Angeles (Chen, Foo, Jung).

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spelling	Pool, Kara-LeeAdachi, KristinaKarnezis, StelliosSalamon, NorikoRomero, TahminehNielsen-Saines, KarinPone, Sheila MouraBoechat, Marcia Cristina BastosAibe, Mitsue SenraSilva, Tallita Gomes daRibeiro, Carla Trevisan MartinsBoechat, M. InesBrasil, PatríciaZin, AndreaTsui, IrenaGaw, Stephanie L.Daltro, PedroRibeiro, Bianca GuedesFazecas, TatianaCruz, L. Celso Hygino daNogueira, RenataVasconcelos, Zilton Farias Meira dePereira, Jose PauloSalles, Tania Regina Dias SaadBarbosa, Claudia NevesChen, WeiqiangFoo, Suan-SinJung, JaeMoreira, Maria Elisabeth LopesPone, Marcos Vinicius da Silva2019-09-12T14:05:01Z2019-09-12T14:05:01Z2019POOL, Kara-Lee et al. Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil. JAMA Network Open, v. 2, n. 7, p. 1-14, July 2019.2574-3805https://www.arca.fiocruz.br/handle/icict/3552710.1001/jamanetworkopen.2019.81242574-3805Patrícia Brasil. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento. David Geffen School of Medicine, University of California, Los Angeles (Pool, Adachi, Karnezis, Salamon, Romero, Nielsen-Saines, M. I. Boechat, Tsui); Fundação Oswaldo Cruz, Rio de Janeiro, Brazil (S. Pone, M. Boechat, Aibe, Gomes da Silva, C. T. M. Ribeiro, Brasil, Zin, Vasconcelos, Pereira, Saad Salles, Barbosa, Moreira, M. Pone); University of California San Francisco School of Medicine (Gaw); Clinica de Diagnostico por Imagem CDPI, Rio de Janeiro, Brazil (Daltro, B. G. Ribeiro, Fazecas, Hygino da Cruz, Nogueira); University of Southern California School of Medicine, Los Angeles (Chen, Foo, Jung).Múltipla - Ver em Notas.IMPORTANCE: Congenital Zika virus (ZIKV) infection may present with a spectrum of clinical and neuroradiographic findings. OBJECTIVE: To determine whether neuroimaging findings for infants with a history of ZIKV exposure are associated with infant clinical outcomes and gestational age at antenatal ZIKV infection. DESIGN, SETTING, AND PARTICIPANTS This cohort study retrospectively reviewed neuroimaging results (computed tomography and/or magnetic resonance imaging scans) of 110 ZIKV-exposed infants from a maternity and children’s hospital in Rio de Janeiro, Brazil, following the 2015 to 2016 ZIKV epidemic. Neuroimaging from March 1, 2016, to June 30, 2017, was evaluated to determine whether findings were associated with clinical outcomes and the timing of maternal ZIKV infection. Data were analyzed from July 1, 2017, to August 30, 2018. EXPOSURES: Neuroimaging (computed tomography and/or magnetic resonance imaging) was performed on ZIKV-exposed infants after birth. Blood and/or urine specimens from mothers and infants were tested for ZIKV by polymerase chain reaction assay. MAIN OUTCOMES AND MEASURES: Neuroimaging studies were evaluated for structural abnormalities and other forms of brain injury. RESULTS: A total of 110 infants with a mean (SD) gestational age of 38.4 (2.1) weeks had neuroimaging and clinical outcome data reviewed. Of these, 71 (65%) had abnormal neuroimaging findings, with the majority (96%) classified as having severe ZIKV infection at birth. The most common neuroimaging abnormalities were structural abnormalities including brain calcifications, especially at the cortico-subcortical white matter junction, cortex malformations, ventriculomegaly, and reduced brain volumes, followed by brainstem hypoplasia, cerebellar hypoplasia, and corpus callosum abnormalities. Frequency of abnormal imaging was higher in infants with specific clinical findings as opposed to those without them; these findings included fetal brain disruption sequence (100% vs 35%), microcephaly (100% vs 30%), congenital contractures (100% vs 58%), ophthalmologic abnormalities (95% vs 44%), hearing abnormalities (100% vs 58%), and neurologic symptoms (94% vs 10%). Four of 39 infants (10%) without initial evidence of severe ZIKV infection and normal findings on neurologic evaluation at birth had abnormal neuroimaging findings. Neuroimaging abnormalities differed by trimester of maternal ZIKV infection, with 63% of infants born to mothers infected in the first trimester, 13% of infants born to mothers infected in the second trimester, and 1% of infants born to mothers infected in the third trimester exhibiting neuroimaging abnormalities. The odds of abnormal neuroimaging were 7.9 times greater for infants with first trimester ZIKV exposure compared with other trimesters combined (odds ratio, 7.9; 95% CI, 3.0-20.4; P < .001). CONCLUSIONS AND RELEVANCE: Neuroimaging abnormalities of computed tomography and/or magnetic resonance imaging scans were common in ZIKV-exposed infants. While neuroimaging abnormalities were seen in 10% of infants without clinically severe ZIKV, most occurred almost exclusively among those with clinically severe ZIKV, especially among those with a history of ZIKV exposure in the first trimester.engJAMA NetworkAssociation between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleZika virusChildrenMaternal ZIKV infectionNeuroimagingRio de JaneiroBrazilinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.pt_BR.fl_str_mv	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil
title	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil
spellingShingle	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil Pool, Kara-Lee Zika virus Children Maternal ZIKV infection Neuroimaging Rio de Janeiro Brazil
title_short	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil
title_full	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil
title_fullStr	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil
title_full_unstemmed	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil
title_sort	Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil
author	Pool, Kara-Lee
author_facet	Pool, Kara-Lee Adachi, Kristina Karnezis, Stellios Salamon, Noriko Romero, Tahmineh Nielsen-Saines, Karin Pone, Sheila Moura Boechat, Marcia Cristina Bastos Aibe, Mitsue Senra Silva, Tallita Gomes da Ribeiro, Carla Trevisan Martins Boechat, M. Ines Brasil, Patrícia Zin, Andrea Tsui, Irena Gaw, Stephanie L. Daltro, Pedro Ribeiro, Bianca Guedes Fazecas, Tatiana Cruz, L. Celso Hygino da Nogueira, Renata Vasconcelos, Zilton Farias Meira de Pereira, Jose Paulo Salles, Tania Regina Dias Saad Barbosa, Claudia Neves Chen, Weiqiang Foo, Suan-Sin Jung, Jae Moreira, Maria Elisabeth Lopes Pone, Marcos Vinicius da Silva
author_role	author
author2	Adachi, Kristina Karnezis, Stellios Salamon, Noriko Romero, Tahmineh Nielsen-Saines, Karin Pone, Sheila Moura Boechat, Marcia Cristina Bastos Aibe, Mitsue Senra Silva, Tallita Gomes da Ribeiro, Carla Trevisan Martins Boechat, M. Ines Brasil, Patrícia Zin, Andrea Tsui, Irena Gaw, Stephanie L. Daltro, Pedro Ribeiro, Bianca Guedes Fazecas, Tatiana Cruz, L. Celso Hygino da Nogueira, Renata Vasconcelos, Zilton Farias Meira de Pereira, Jose Paulo Salles, Tania Regina Dias Saad Barbosa, Claudia Neves Chen, Weiqiang Foo, Suan-Sin Jung, Jae Moreira, Maria Elisabeth Lopes Pone, Marcos Vinicius da Silva
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.contributor.author.fl_str_mv	Pool, Kara-Lee Adachi, Kristina Karnezis, Stellios Salamon, Noriko Romero, Tahmineh Nielsen-Saines, Karin Pone, Sheila Moura Boechat, Marcia Cristina Bastos Aibe, Mitsue Senra Silva, Tallita Gomes da Ribeiro, Carla Trevisan Martins Boechat, M. Ines Brasil, Patrícia Zin, Andrea Tsui, Irena Gaw, Stephanie L. Daltro, Pedro Ribeiro, Bianca Guedes Fazecas, Tatiana Cruz, L. Celso Hygino da Nogueira, Renata Vasconcelos, Zilton Farias Meira de Pereira, Jose Paulo Salles, Tania Regina Dias Saad Barbosa, Claudia Neves Chen, Weiqiang Foo, Suan-Sin Jung, Jae Moreira, Maria Elisabeth Lopes Pone, Marcos Vinicius da Silva
dc.subject.en.pt_BR.fl_str_mv	Zika virus Children Maternal ZIKV infection Neuroimaging Rio de Janeiro Brazil
topic	Zika virus Children Maternal ZIKV infection Neuroimaging Rio de Janeiro Brazil
description	Patrícia Brasil. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento. David Geffen School of Medicine, University of California, Los Angeles (Pool, Adachi, Karnezis, Salamon, Romero, Nielsen-Saines, M. I. Boechat, Tsui); Fundação Oswaldo Cruz, Rio de Janeiro, Brazil (S. Pone, M. Boechat, Aibe, Gomes da Silva, C. T. M. Ribeiro, Brasil, Zin, Vasconcelos, Pereira, Saad Salles, Barbosa, Moreira, M. Pone); University of California San Francisco School of Medicine (Gaw); Clinica de Diagnostico por Imagem CDPI, Rio de Janeiro, Brazil (Daltro, B. G. Ribeiro, Fazecas, Hygino da Cruz, Nogueira); University of Southern California School of Medicine, Los Angeles (Chen, Foo, Jung).
publishDate	2019
dc.date.accessioned.fl_str_mv	2019-09-12T14:05:01Z
dc.date.available.fl_str_mv	2019-09-12T14:05:01Z
dc.date.issued.fl_str_mv	2019
dc.type.status.fl_str_mv	info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv	info:eu-repo/semantics/article
format	article
status_str	publishedVersion
dc.identifier.citation.fl_str_mv	POOL, Kara-Lee et al. Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil. JAMA Network Open, v. 2, n. 7, p. 1-14, July 2019.
dc.identifier.uri.fl_str_mv	https://www.arca.fiocruz.br/handle/icict/35527
dc.identifier.issn.pt_BR.fl_str_mv	2574-3805
dc.identifier.doi.none.fl_str_mv	10.1001/jamanetworkopen.2019.8124
dc.identifier.eissn.pt_BR.fl_str_mv	2574-3805
identifier_str_mv	POOL, Kara-Lee et al. Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil. JAMA Network Open, v. 2, n. 7, p. 1-14, July 2019. 2574-3805 10.1001/jamanetworkopen.2019.8124
url	https://www.arca.fiocruz.br/handle/icict/35527
dc.language.iso.fl_str_mv	eng
language	eng
dc.rights.driver.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	JAMA Network
publisher.none.fl_str_mv	JAMA Network
dc.source.none.fl_str_mv	reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ
instname_str	Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str	FIOCRUZ
institution	FIOCRUZ
reponame_str	Repositório Institucional da FIOCRUZ (ARCA)
collection	Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv	https://www.arca.fiocruz.br/bitstream/icict/35527/1/license.txt https://www.arca.fiocruz.br/bitstream/icict/35527/2/ve_Pool_Kara-Lee_etal_INI_2019.pdf https://www.arca.fiocruz.br/bitstream/icict/35527/3/ve_Pool_Kara-Lee_etal_INI_2019.pdf.txt
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Association between neonatal neuroimaging and clinical outcomes in Zika-exposed infants from Rio de Janeiro, Brazil

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