Orofacial alterations of Congenital Syndrome by Zika Virus in different periods of infection in pregnancy

Objective: To estimate and compare the prevalence of orofacial changes in children with Congenital Zika Virus Syndrome (SCVZ) with different periods of infection in pregnancy, according to social, demographic, and clinical characteristics. Method: Cross-sectional study nested to a cohort of 108 children with SCVZ seen in a reference center for this disorder in Maranhão in the period from October 2016 and July 2019. The orofacial changes (face, lips, palate, tongue, oral mucosa and teeth) were assessed through clinical examination under artificial light in knee-knee position, while the social and clinical characteristics, through medical records and interviews. The children were divided into two groups according to the trimester of pregnancy in which the mother was infected: 1st trimester (n=56) and 2nd/3rd trimester (n=52). To compare if there was a difference in orofacial changes between the two groups chi-square and Fisher's exact test was performed at 5% significance level (p<0.05). Results: The prevalence of orofacial changes in children with SCVZ was 90.7% (n=97), with no statistically significant difference (p=0.38) between those infected in the 1st trimester 76.8% (n=43) and in the 2nd/3rd trimesters 69.2% (n=36). Atresia of the palate was the most prevalent type of alteration 67.6% (n=73). Two children had cleft lip and palate (1.8%), both infected in the 1st trimester. Lingual frenum alteration was observed in 17.9% (n=10) in the 1st trimester infected group and 11.6% (n=6) in the other group (p=0.35). Conclusion: Regardless of the time of infection, orofacial changes in children with SCVZ were similar in both groups of pregnant women infected in the 1st trimester and in those in the 2nd/3rd trimesters.