Fatores sociodemográficos de mães e clínicos de crianças com microcefalia associados à infecção pelo Zika vírus

Abstract

Introduction: Microcephaly is defined as the reduction of the cephalic perimeter for at least two standard deviations in relation to the sex and gestational age of the child. In 2015, in the face of the outbreak of Zika virus in the country and its relation with the high incidence of live births with microcephaly, studies that contributed to the understanding of this new epidemic became necessary, since little is known about the theme. Thus, the general aim of the research was: To investigate the association between the sociodemographic factors of mothers and clinical factors of children with microcephaly associated with infection by zika virus. As specific aims: 1. To characterize the mothers of children with microcephaly according to sociodemographic factors; 2. Identify the clinical characteristics of children with microcephaly; 3. To estimate the prevalence of Zika virus infection in children with microcephaly; 4. To verify the association between the sociodemographic factors of mothers and clinical of children with microcephaly and estimate the prevalence of Zika virus infection in these children. Methods: Cross-sectional study conducted at a State Hospital in Salvador, Bahia, Brazil, with a population comprised of 51 infants and their respective mothers. Data were obtained by applying structured interviews to investigate the sociodemographic data of mothers and a clinical evaluation with general neurological approach to the children. It was performed a descriptive analysis of all the variables studied by calculating the absolute and relative frequencies for categorical variables, mean with standard deviation in the case of continuous variables, followed by the construction of tables. As a measure of association, PR (Prevalence Ratio) was estimated, with a 95% Confidence Interval (95% CI), in bivariate and multivariate analyzes. Results: the mean age of the mothers was 25 years (SD 6.28). Regarding race/color, the predominance of blacks (86.27%) was observed, and for marital status there was no significant difference between married (49.03%) and single women (50.98%), schooling was 58,82% for high school, with 88.24% unemployed and 90.2% had a mosquito focus in their homes. Regarding sociodemographic data of the mothers, there was no statistical significance due to the homogeneity of the studied population, but the variables schooling, occupation and focus of the mosquito had a non-significant positive association, with a prevalence ratio of (1.27); (1.67) and (2.06) respectively. The univariate logistic regression analysis for the clinical data, showed the reflexes of moro, palmar grasp, rooting, walking, asphyxia escape, axial hypotonia, appendicular hypertonia with and without stimulation, hyperreflexia, irritability and tremors, as factors associated with microcephaly due to infection with Zika Virus. Of these, only the variable walking was identified as a factor independently associated to the outcome, according to the multivariate model. Conclusion: this study pointed out the clinical factors associated with Zika virus infection in children with microcephaly in the studied population. Although sociodemographic data have not reached statistical significance, it is essential to conduct an evaluation that considers the context in which the child is inserted so that early intervention strategies are designed to optimize the development of these children.