Congenital Zika Syndrome: growth, clinical and motor development outcomes up to 36 months of age and differences according to microcephaly at birth.

Abstract Background Little is known regarding developmental consequences of Congenital Zika Syndrome (CZS) without microcephaly at birth. Most clinical series published to date were descriptive and had small sample sizes. Study design We conducted a cohort study to compare growth, clinical and motor development outcomes of 110 children with CZS born with and without microcephaly up to their 3rd birthday. Ninety-three had their head circumference (HC) at birth abstracted and did not have hypertensive hydrocephalus at birth, of these, 61 were born with and 32 without microcephaly. Results HC z-scores dropped steeply from birth to six months of age, from −3.77 to −6.39 among those with and from −1.03 to −3.84 among those without microcephaly at birth. Thus at 6 months of age children born without microcephaly had their mean HC z-scores nearly at the same value those born with microcephaly had at birth. Children born without microcephaly were less likely to have brain damage, ophthalmic abnormalities and drug-resistant epilepsy, but differences for many conditions were not statistically significant. Conclusions Children born without microcephaly were only slightly less likely to present severe neurologic impairment, tend to develop postnatal-onset microcephaly and some original differences between the groups tend to dissipate with age.