Congenital Neurological Disorders in Children with Microcephaly Related to Exanthematous Diseases During Pregnancy: A Cohort Study

Abstract Background: An increase in the prevalence of microcephaly (MCP) was seen in Rio Grande do Norte State (RN) since September 2015. This Brazilian northeast state was highly impacted by a Zika (ZIKV) outbreak in the last 2 years. The highest rate of MCP was in November 2015 with 20.1 cases per 1,000 live births, compared with 1.8 cases/year in the previous years. Our study aimed to evaluate the neurological disorders in children with microcephaly whose mothers had exanthematous disease (ED) during the pregnancy. Methods: We evaluated children up to 17 months old followed at a children rehabilitation center in RN. Cohort enrollment occurred with children born between January 2015 and May 2016. We interviewed their mothers about the occurrence of ED during their pregnancy. Results: Of the 37 cases of MCP (25 male, 12 girls), 10 mothers did not know how to describe The presence of ED during pregnancy. Of the 24 cases of MCP with maternal ED, 9 patients were classified as having severe spasticity (Ashworth score 3 and 4), 4 patients were classified as mild (Ashworth score 1e 2) and 11 had no spasticity. Eleven patients had seizure disorders and 5 reported irritability. Conclusion: According to this data, there is a high prevalence of neurological complications in children with MCP related to ED. These patients need close follow-up care and intensive medical interventions. Longer follow-up will provide data regarding these chronic neurological complications and how best to intervene. Disclosures All authors: No reported disclosures