Microcephaly in South Brazil: Are cases of Congenital Zika Syndrome increasing in recent years?

Northeast Brazil was the first region to detect a significant increase in babies born with microcephaly associated with prenatal zika virus infection in 2015. Rio Grande do Sul (RS) state was less impacted due to the temperate climate preventing the spread of the vector. This study investigated the prevalence and etiology of congenital microcephaly in RS in two different periods. This cross-sectional descriptive study included all live births with congenital microcephaly in RS from 2015 to 2022. Cases were divided into two groups: P1 "outbreak" (2015-16); and P2 "endemic" (2017-22). There were 58 cases of microcephaly (3.8/10,000) in P1 and 148 (1.97/10,000) in P2. Congenital Zika Virus infection was the etiology in 5.2% (n=3) in P1 and 6.7% (n=10) in P2. In conclusion, although the ZIKV outbreak in Brazil has receded, RS remains an area of concern, with a possible slight increase of live births with microcephaly secondary to ZIKV prenatal infection relative to the number of cases due to congenital infections. The broader distribution of the vector Aedes aegypti with warmer temperatures in our state might be linked to the increase in recent years. This study can be an alert to other regions of temperate or subtropical climates.

Fetal Alcohol Spectrum Disorders: Health Needs Assessment in Brazil.

BACKGROUND: Fetal alcohol syndrome (FAS) is a disorder caused by alterations in embryo-fetal development due to prenatal alcohol exposure. It is estimated that between 0.5 and 2 per 1,000 individuals are born with FAS every year. In Brazil, there are few studies addressing the extent of the problem of FAS/fetal alcohol spectrum disorders (FASD); these studies are confined to limited geographic areas. Therefore, we decided to perform a health needs assessment for FAS/FASD in Brazil. METHODS: To estimate the prevalence of FAS and FASD in Brazil, we used information from the literature, which estimates between 0.5 and 2/1,000 births per year for FAS and 10 to 50/1,000 for FASD. RESULTS: We estimated that approximately 1,500 to 6,000 children are born with FAS every year. Considering the whole population, the prevalence would be 95,377 to 380,000 affected people. However, when we consider FASD as a whole, we estimate that between 1,900,000 and 9,500,000 Brazilians might suffer the more severe consequences of alcohol exposure during pregnancy and be living with FASD. CONCLUSION: The results of the current study indicate that FAS and FASD are prevalent disorders in Brazil, and more policies targeting alcohol intake during pregnancy must be developed.

Idade materna e condições perinatais, entre nascimentos de risco de 2008 a 2013 / Maternal age and perinatal conditions between births at risk from 2008 to 2013 / Edad materna y condiciones perinatales, entre nacimientos de riesgo de 2008 a 2013

Objetivo: investigar el perfil de los recién nacidos y de las puérperas (Mujer que hace muy poco que ha parido) con edad hasta 19 años y superior a 35 años, catastradas en el "Programa Prá-Nenê". Metodología: estudio transversal, observacional, descriptivo, retrospectivo, con abordaje cuantitativo. Los datos fueron obtenidos a través del banco de datos del "Programa de Vigilância de Recém-nascido de risco Prá-nenê", en el período de 2008 a 2013, en municipio de Pelotas-RS. Se utilizó el software Stata 12.0 para el análisis descriptivo de las variables. El presente estudio fue aprobado por el comité de ética en investigación sob nº13348013.8.0000.5317. Resultados: la muestra fue de 1306 puérperas, de estas 706 eran adolescentes y 600 tenían 35 años o más. Se evidenció que las adolescentes realizaron menor número de consultas de prenatal (43,8%) e iniciaron más tardíamente el seguimiento cuando comparadas con mujeres maduras. La frecuencia de partos vaginales disminuye con el aumento de la edad (38,2%). Los recién nacidos de puérperas adolescentes tuvieron un mayor bajo peso al nacer (43,9%), mientras que las madres tuvieron hijos con mayor peso al nacer (37,6%). Conclusión: se reafirma así la necesidad de mayores inversiones en la prevención y promoción de la salud materna, principalmente en los extremos de edad.

Objetivo: investigar o perfil dos recém-nascidos e das puérperas com idade até 19 anos e superior a 35 anos, cadastradas no "Programa Prá-Nenê". Metodologia: estudo transversal, observacional, descritivo, retrospectivo, com abordagem quantitativa. Os dados foram obtidos através do banco de dados do "Programa de Vigilância de Recém-nascido de risco Prá-nenê", período de 2008 a 2013, no município de Pelotas-RS. Foi utilizado o Software Stata 12.0 para análise descritiva das variáveis. O presente estudo foi aprovado pelo comitê de ética em pesquisa sob nº 13348013.8.0000.5317. Resultados: a amostra foi de 1306 puérperas, destas 706 eram adolescentes e 600 tinham 35 anos ou mais. Evidenciou-se que as adolescentes realizaram menor número de consultas de pré-natal (43,8%) e iniciaram mais tardiamente o acompanhamento quando comparadas com mulheres maduras. A frequência de partos vaginais diminui com o aumento da idade (38,2%). Os recém-nascidos de puérperas adolescentes tiveram um maior baixo peso ao nascer (43,9%), enquanto as mães maduras tiveram filhos com maior peso ao nascer (37,6%). Conclusão: reafirma-se assim a necessidade de maiores investimentos na prevenção e promoção da saúde materna, principalmente nos extremos etários.

Objective: investigating the profile of the newborns and the puerperal women aged until 19 years old and older than 35 years old registered at "Programa Prá-Nenê". Methodology: a cross-sectional observational study, with descriptive, retrospective and quantitative approach. Software Stata 12.0 was used for descriptive analysis of the variables. Data were obtained from the "Programa de Vigilância de Recém-Nascido Prá-Nenê" database, from 2008 to 2013, in Pelotas-RS. This study was approved by the local research ethics committee by nº 13348013.8.0000.5317. Results: the sample contained 1306 puerperal women, of which 706 were adolescents and 600 were 35 years old or more. It was evidenced that adolescents had a smaller amount of prenatal visits (43,8%) and had their first prenatal visit later in gestation when compared to mature women. The frequency of vaginal delivery gets smaller with the increase in age (38,2%). The newborns from puerperal teenagers had a smaller birth weight (43,9%), while mature women had newborns with a bigger birth weight. Conclusions: the necessity of more investments in health prevention and promotion is reassured, mainly in early and mature reproductive ages

Epidemiological profile of 39 cases of microcephaly caused by congenital infections diagnosed in the state of Rio Grande do Sul between 2015-2017

Introduction: Microcephaly is a clinical finding that can arise from congenital anomalies or emerge after childbirth. Maternal infections acquired during pregnancy can result in characteristic brain damage in the newborn (NB), which may be visible even in the fetal stage. To describe the epidemiological profile of newborns with reported microcephaly and diagnosed with congenital infections in the state of Rio Grande do Sul between 2015 and 2017. Methods: A cross-sectional study was carried out on data collected from the Public Health Event Registry as well as from medical records. The investigation included serologies for toxoplasmosis and rubella; polymerase chain reaction (PCR) for Zika virus (ZIKV) in the blood and cytomegalovirus in the urine; non-treponemal tests for syphilis; and brain imaging tests. Results: Of the 257 reported cases of microcephaly, 39 were diagnosed with congenital infections. Severe microcephaly was identified in 13 patients (33.3%) and 51.3% of the cases showed alterations in brain imaging tests. In relation to the diagnosis of congenital infections, three patients (7.7%) were diagnosed with ZIKV, nine (23.1%) with cytomegalovirus, nine (23.1%) with toxoplasmosis, and 18 (46.1%) with congenital syphilis. The three cases of ZIKV showed calcification in brain imaging tests, signs of arthrogryposis, excess occipital skin and irritability, characterizing the typical phenotype of ZIKV infection. Conclusions: Most cases of congenital infection had severe neurological lesions, particularly the cases of ZIKV, which can cause neurodevelopmental delays and sequelae in these infants throughout early childhood.

A hospitalização na perspectiva da criança: uma revisão integrativa / Hospitalization in the child´s perspective: an integrative review

Objetivo: analisar a publicação científica sobre a hospitalização na perspectiva da criança. Método: revisãointegrativa que buscou conhecer as publicações dos últimos 10 anos sobre a perspectiva da criança acerca dasua hospitalização. Selecionaram-se quatro bases de dados para as buscas: LILACS, Sage Journals, MEDLINE eBDENF. Resultados: foram definidas quatro categorias temáticas: 1. A percepção da criança sobre a doença ea hospitalização; 2. Estratégias de entretenimento durante a hospitalização infantil; 3. A família como redede apoio à criança; 4. Cuidado à criança durante a hospitalização. Destacaram-se nos estudos a importânciada adoção de estratégias de comunicação adequada, bem como do uso do brinquedo no cuidado às crianças.Conclusão: durante a hospitalização, a criança é afastada do seu ambiente e atividades rotineiras,entretanto, se o cuidado oferecido pelos profissionais for adequado, os sentimentos negativos como o medo ea ansiedade podem ser minimizados.