Aspectos da linguagem e do comportamento de crianças sem microcefalia expostas à infecção materna pelo vírus Zika
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Data
2021-11-22
Autores
Sicchieri, Bianca Bortolai
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Os efeitos da infecção intraútero do vírus Zika sobre o cérebro em formação foram recentemente descritos, sendo a microcefalia uma das principais manifestações. Ainda dispomos de poucos conhecimentos sobre os efeitos desta infecção sobre a trajetória neurodesenvolvimental das crianças consideradas assintomáticas ao nascimento. Objetivo: Investigar aspectos da linguagem e do comportamento de crianças sem microcefalia expostas à infecção materna pelo vírus Zika (ZIKV). Método: Foi conduzido estudo observacional, transversal numa coorte de crianças nascidas em 2016, cujas mães foram infectadas pelo ZIKV na gestação. Participaram 38 crianças sem microcefalia, sendo 19 expostas ao ZIKV que foram comparadas à 19 não expostas e com histórico neurodesenvolvimental típico. Trinta minutos de interação lúdica e dialógica foi utilizado para investigar aspectos pragmáticos da linguagem e do comportamento do brincar os quais foram registros por meio do Protocolo de Observação Comportamental (PROC). O vocabulário expressivo foi investigado por meio do Teste de Nomeação Infantil (TIN) e pelo inventário de vocabulário expressivo do Questionário de Desenvolvimento de Linguagem (LDS), parte do inventário comportamental Child Behavior Checklist (CBCL) para crianças de 1.5-5 anos. O CBCL também foi utilizado para o levantamento de problemas comportamentais. Os dados foram analisados por meio de estatística descritiva e inferencial. Resultados: Diferenças estatisticamente significantes foram encontradas entre os grupos ZIKV e Comparativo. Crianças do grupo ZIKV apresentaram desempenho inferior nos aspectos pragmáticos da linguagem, menor uso de funções comunicativas (informativa e narrativa), nível inferior de meios de comunicação verbal, de contextualização, de compreensão verbal e vocabulário expressivo quando comparadas às crianças do grupo comparativo. Também apresentaram pontuação inferior no nível de organização do brinquedo. Mais escores clínicos foram encontrados para as crianças do grupo ZIKV nas escalas individuais de problemas de atenção e agressividade, e nas escalas orientadas pelo DSM-5 de estresse, Transtorno de Déficit de Atenção e Hiperatividade e Transtorno Opositivo Desafiador. Correlação negativa foi encontrada entre aspectos pragmáticos da linguagem com problemas comportamentais. Conclusão: Os resultados obtidos indicaram possíveis efeitos da exposição intraútero ao vírus Zika sobre o desenvolvimento da linguagem e do comportamento das crianças neste estudo. Estudos adicionais e com amostra ampliada ainda são necessários para confirmar se as manifestações observadas constituem parte de um espectro de manifestações causadas pelo vírus Zika.
Introduction: The effects of intrauterine Zika virus infection on the developing brain have been recently described, with microcephaly being one of the main manifestations. We still have little knowledge about the effects of this infection on the neurodevelopmental trajectory of children considered asymptomatic at birth. Objective: To investigate language and behavior aspects of children without microcephaly exposed to maternal Zika virus (ZIKV) infection. Method: An observational, cross-sectional study was conducted in a cohort of children born in 2016, whose mothers were infected with ZIKV during pregnancy. Thirty-eight children without microcephaly participated, being 19 exposed to ZIKV who were compared to 19 not exposed and with typical neurodevelopmental history. Thirty minutes of playful and dialogic interaction was used to investigate pragmatic aspects of language and play behavior, which were recorded through the Behavioral Observation Protocol (PROC). Expressive vocabulary was investigated using the Child Naming Test (TIN) and the expressive vocabulary inventory of the Language Development Questionnaire (LDS), part of the Child Behavior Checklist (CBCL) behavioral inventory for children aged 1.5-5 years. The CBCL was also used to survey behavioral problems. Data were analyzed using descriptive and inferential statistics. Results: Statistically significant differences were found between the ZIKV and Comparative groups. Children in the ZIKV group showed lower performance in the pragmatic aspects of language, less use of communicative functions (informative and narrative), lower level of means of verbal communication, contextualization, verbal comprehension and expressive vocabulary when compared to children in the comparative group. They also had lower scores in the toy organization level. More clinical scores were found for children in the ZIKV group on the individual scales of attention problems and aggression, and on the DSM-5-oriented scales of stress, Attention-Deficit Hyperactivity Disorder, and Oppositional Defiant Disorder. Negative correlation was found between pragmatic aspects of language and behavioral problems. Conclusion: The results obtained indicated possible effects of intrauterine exposure to the Zika virus on the language development and behavior of children in this study. Additional studies with an expanded sample are still needed to confirm whether the observed manifestations are part of a spectrum of manifestations caused by the Zika virus.
Introduction: The effects of intrauterine Zika virus infection on the developing brain have been recently described, with microcephaly being one of the main manifestations. We still have little knowledge about the effects of this infection on the neurodevelopmental trajectory of children considered asymptomatic at birth. Objective: To investigate language and behavior aspects of children without microcephaly exposed to maternal Zika virus (ZIKV) infection. Method: An observational, cross-sectional study was conducted in a cohort of children born in 2016, whose mothers were infected with ZIKV during pregnancy. Thirty-eight children without microcephaly participated, being 19 exposed to ZIKV who were compared to 19 not exposed and with typical neurodevelopmental history. Thirty minutes of playful and dialogic interaction was used to investigate pragmatic aspects of language and play behavior, which were recorded through the Behavioral Observation Protocol (PROC). Expressive vocabulary was investigated using the Child Naming Test (TIN) and the expressive vocabulary inventory of the Language Development Questionnaire (LDS), part of the Child Behavior Checklist (CBCL) behavioral inventory for children aged 1.5-5 years. The CBCL was also used to survey behavioral problems. Data were analyzed using descriptive and inferential statistics. Results: Statistically significant differences were found between the ZIKV and Comparative groups. Children in the ZIKV group showed lower performance in the pragmatic aspects of language, less use of communicative functions (informative and narrative), lower level of means of verbal communication, contextualization, verbal comprehension and expressive vocabulary when compared to children in the comparative group. They also had lower scores in the toy organization level. More clinical scores were found for children in the ZIKV group on the individual scales of attention problems and aggression, and on the DSM-5-oriented scales of stress, Attention-Deficit Hyperactivity Disorder, and Oppositional Defiant Disorder. Negative correlation was found between pragmatic aspects of language and behavioral problems. Conclusion: The results obtained indicated possible effects of intrauterine exposure to the Zika virus on the language development and behavior of children in this study. Additional studies with an expanded sample are still needed to confirm whether the observed manifestations are part of a spectrum of manifestations caused by the Zika virus.
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Palavras-chave
Linguagem infantil, Comportamento, Desenvolvimento infantil, Infeção por vírus Zika, Child language, Behavior, Child development, Zika virus infection