Early Clinical Infancy Outcomes for Microcephaly and/or Small for Gestational Age Zika-Exposed Infants

Abstract Background Zika-exposed infants with microcephaly (proportional or disproportional) and those who are small for gestational age without microcephaly should be closely followed, particularly their growth trajectories. They are at high risk of adverse outcomes in the first year of life. Antenatal Zika virus (ZIKV) exposure may lead to adverse infant outcomes including microcephaly and being small for gestational age (SGA). ZIKV-exposed infants with a diagnosis of microcephaly (proportional [PM] or disproportional [DM]) or SGA at birth were evaluated with anthropometric measurements and health outcomes. Methods Infants had laboratory-confirmed ZIKV exposure in Brazil. PM, DM, or SGA classification was based on head circumference and weight. First-year growth parameters and clinical outcomes were recorded with analyses performed. Results Among the 156 ZIKV-exposed infants, 14 (9.0%) were SGA, 13 (8.3%) PM, 13 (8.3%) DM, and 116 (74.4%) were neither SGA nor had microcephaly (NSNM). High rates of any neurologic, ophthalmologic, and hearing abnormalities were observed for PM (100%), DM (100%), and SGA (42.9%) vs NSNM infants (18.3%; P <.001); odds ratio [OR], 3.4 (95% confidence interval [CI], 1.1–10.7) for SGA vs NSNM. Neuroimaging abnormalities were seen in 100% of PM and DM and in 42.9% of SGA vs NSNM infants 16%; (P <.001); OR 3.9 (95% CI, 1.2–12.8) for SGA vs NSNM. Growth rates by z score, particularly for microcephaly infants, were poor after birth but showed improvement beyond 4 months of life. Conclusions ZIKV-exposed infants with microcephaly (PM and DM) had similarly high rates of adverse outcomes but showed improvement in growth measurements beyond 4 months of life. While SGA infants had fewer adverse outcomes compared with microcephaly infants, notable adverse outcomes were observed in some; their odds of having adverse outcomes were 3 to 4 times greater compared to NSNM infants. Zika-exposed infants with microcephaly, irrespective of being proportional or disproportional, and those who are small for gestational age without microcephaly should be closely followed, particularly their growth trajectories. They are at high risk of adverse outcomes in the first year of life.

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Increased Risk of Malaria During the First Year of Life in Small-for-Gestational-Age Infants: A Longitudinal Study in Benin

The Journal of Infectious Diseases ◽

10.1093/infdis/jiy699 ◽

2018 ◽

Vol 219 (10) ◽

pp. 1642-1651 ◽

Cited By ~ 1

Author(s):

Gino Agbota ◽

Manfred Accrombessi ◽

Gilles Cottrell ◽

Yves Martin-Prével ◽

Jacqueline Milet ◽

...

Keyword(s):

Longitudinal Study ◽

Gestational Age ◽

Small For Gestational Age ◽

First Year ◽

Increased Risk ◽

First Year Of Life

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The premature small-for-gestational-age infant during the first year of life: Comparison by birth weight and gestational age

The Journal of Pediatrics ◽

10.1016/s0022-3476(88)80584-5 ◽

1988 ◽

Vol 113 (6) ◽

pp. 1066-1073 ◽

Cited By ~ 58

Author(s):

Ivette C. Pena ◽

Annabel J. Teberg ◽

Karen M. Finello

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

First Year ◽

First Year Of Life

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Demographic and Clinical Features of Small-for-Gestational-Age Infants Born to Mothers With Gestational Diabetes Mellitus

Frontiers in Pediatrics ◽

10.3389/fped.2021.741793 ◽

2021 ◽

Vol 9 ◽

Author(s):

Juncao Chen ◽

Huimin Xiao ◽

Yong Yang ◽

Yaping Tang ◽

Xiaoqi Yang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

First Year ◽

Retrospective Case ◽

Adverse Perinatal Outcomes ◽

First Year Of Life

We studied the demographic and clinical characteristic, risk factors, outcomes of full-term small-for-gestational-age (SGA) infants born to mothers with gestational diabetes mellitus (GDM) in China. A retrospective case-control study that included 1981 SGA infants was conducted; the demographic and clinical data between SGA infants born to mothers with and without GDM were compared. Of 383 SGA infants born to mothers with GDM, 221 (57.7%) were female, and the incidence of these infants was 1 in 155 live births. The risk of SGA siblings (RR, 1.88; 95% CI, [1.23–2.86]), low 1- and 5-min Apgar scores (RR,2.04 and 4.21; 95%CI [1.05–4.00] and [1.05–16.89], respectively), early thrombocytopenia (RR, 3.39; 95%CI, [1.33–8.64]), hypoglycemia(RR, 2.49; 95%CI, [1.55–3.98]), and hypoxic-ischemic encephalopathy (RR,5.61; 95%CI, [1.25–25.18]) were increased in SGA infants born to mothers with GDM compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had a significantly higher ratio of catch-up growth (CUG) (RR, 1.73; 95%CI, [1.18–2.54]) in the first year of life. These results show that genetic factors may be one of the etiologies of SGA infants born to mothers with GDM; and these infants have more adverse perinatal outcomes compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had accelerated CUG in the first year of life.

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Small for gestational age and extremely low birth weight infant outcomes

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0295 ◽

2019 ◽

Vol 47 (2) ◽

pp. 247-251 ◽

Cited By ~ 2

Author(s):

Elinor Charles ◽

Katie A. Hunt ◽

Christopher Harris ◽

Ann Hickey ◽

Anne Greenough

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

Length Of Hospital Stay ◽

Extremely Low Birth Weight ◽

Z Score ◽

Oxygen Requirement ◽

Antenatal Corticosteroids ◽

Infant Outcomes ◽

Significant Difference

Abstract Background Small for gestational age (SGA) infants are less likely to develop respiratory distress syndrome (RDS), but more likely to develop bronchopulmonary dysplasia (BPD) and have a higher mortality. Our aim was to focus on outcomes of those with a birth weight less than or equal to 750 g. Methods The mortality, BPD severity, necrotising enterocolitis (NEC), home oxygen requirement and length of hospital stay were determined according to SGA status of all eligible infants in a 5-year period admitted within the first 24 h after birth. Results The outcomes of 84 infants were assessed, and 35 (42%) were SGA. The SGA infants were more mature (P<0.001), had a lower birth weight centile (P<0.001) and a greater proportion exposed to antenatal corticosteroids (P=0.022). Adjusted for gestational age (GA), there was no significant difference in mortality between the two groups (P=0.242), but a greater proportion of the SGA infants developed severe BPD (P=0.025). The SGA infants had a lower weight z-score at discharge (−3.64 vs. −1.66) (P=0.001), but a decrease in z-score from birth to discharge was observed in both groups (median −1.53 vs. −1.07, P=0.256). Conclusion Despite being more mature, the SGA infants had a similar mortality rate and a greater proportion developed severe BPD.

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