Introduction
Methods
Study Design and Participants
Assessing Dysphagia
Statistical Analyses
Ethics
Results
Zika-exposed children without microcephaly (n = 58) | Children with congenital Zika syndrome with microcephaly (n = 58) | p value, χ2 | |
---|---|---|---|
Birth weight | |||
< 2500 g | 7 (12.5%) | 18 (32.7%) | 0.011 |
> 2500 g | 49 (87.5%) | 37 (67.3%) | |
Caregiver report of OPD | |||
No | 55 (94.8%) | 34 (58.6%) | < 0.001*1 |
Yes | 3 (5.2%) | 24 (41.4%) | |
Hospitalization during the previous 6 months | |||
No | 48 (82.8%) | 34 (58.6%) | 0.004 |
Yes | 10 (17.2%) | 24 (41.4%) | |
Alternative food route | |||
No | 55 (94.8%) | 46 (79.3%) | 0.012*1 |
Yes | 3 (5.2%) | 12 (20.7%) | |
Type of alternative food route | |||
Tube (nasogastric) | 3 (100%) | 9 (75%) | 0.484*1 |
Gastrostomy | 3 (25%) | ||
Dysphagia symptoms during feeding | |||
Cough | |||
Yes | 8 (13.8%) | 29 (50%) | < 0.001 |
No | 50 (86.2%) | 29 (50%) | |
Choking | |||
Yes | 2 (3.4%) | 23 (39.7%) | < 0.001*1 |
No | 56 (96.6%) | 35 (60.3%) | |
Cyanosis | |||
Yes | 1 (1.7%) | 4 (6.9%) | 0.182*1 |
No | 57 (98.3%) | 50 (93.1%) | |
Others | |||
Yes | 2 (3.6%) | 7 (12.3%) | 0.081*1 |
No | 55 (96.4%) | 50 (87.7%) |
Zika-exposed children without microcephaly (n = 58) | Children with congenital Zika syndrome with microcephaly (n = 58) | p value, χ2 | |
---|---|---|---|
Body position during feeding*3 | |||
Inappropriate | 8 (14.1%) | 45 (78.9%) | < 0.001 |
Appropriate | 50 (85.9%) | 12 (21.1%) | |
Head position during feeding*4 | |||
Inappropriate | 3 (5.3%) | 13 (22.4%) | 0.007 |
Appropriate | 54 (94.7%) | 45 (77.6%) | |
Resting lip posture | |||
Occluded | 45 (70.3%) | 18 (31.1%) | < 0.001 |
Half open | 12 (20.7%) | 40 (68.9%) | |
Lip tonus | |||
Appropriate for age | 50 (86.4%) | 21 (36.2%) | < 0.001 |
Inappropriate | 8 (13.6%) | 37 (63.8%) | |
Mobility of lips | |||
Retraction (smile) | |||
Yes | 56 (96.6%) | 50 (86.2%) | 0.047*1 |
No | 2 (3.4%) | 8 (13.8%) | |
Pursing of lips | |||
Yes | 56 (96.6%) | 26 (44.8%) | 0.000*1 |
No | 2 (3.4%) | 32 (55.2%) | |
Resting tongue posture | |||
Appropriate (behind the upper teeth) | 26 (44.1%) | 11(18.9%) | 0.003 |
Inappropriate | 32 (55.9%) | 47 (81.1%) | |
Tongue tonus | |||
Normal | 3 (5.2%) | 16 (27.6%) | < 0.001*1 |
Anomalies | 55 (94.8%) | 42 (72.4%) | |
Tongue mobility | |||
Retraction | |||
Yes | 57 (98.3%) | 50 (86.2%) | 0.015*1 |
No | 1 (1.7%) | 8 (13.8%) | |
Protrusion | |||
Yes | 58 (100%) | 50 (86.2%) | < 0.015*1 |
No | – | 17 (29.3%) | |
Lingual frenulum | |||
Typical | 57 (98.3%) | 54 (93.1%) | 0.182*1 |
Shortened | 1 (1.7%) | 4 (6.9%) | |
Cheek tone | |||
Appropriate | 52 (89.7%) | 22 (37.9%) | < 0.001 |
Increased | 1 (1.7%) | 3 (5.2%) | |
Decreased | 5 (8.6%) | 33 (56.9%) | |
Hard palate | |||
Appropriate | 55 (94.8%) | 42(72.4%) | 0.001* |
Inappropriate | 3 (5.2%) | 16 (27.6%) | |
Soft palate | |||
Appropriate | 57 (98.3%) | 58 (100%) | 0.500*1 |
Inappropriate | 1 (1.7%) | – |
Zika-exposed children without microcephaly (n = 58) | Children with congenital Zika syndrome with microcephaly (n = 58) | p value, χ2 | |
---|---|---|---|
Food escaping from mouth | |||
Yes | 5 (8.6%) | 40 (69.9%) | < 0.001 |
No | 53 (91.4%) | 18 (31.1%) | |
Vocal quality | |||
Normal | 57 (98.3%) | 56 (96.6%) | 0.494*1 |
Hoarse/wet | 1 (1.7%) | 2 (3.4%) | |
Cervical auscultation | |||
Normal | 56 (96.6%) | 25 (43.1%) | < 0.001*1 |
Respiratory sounds present | 2 (3.4%) | 33 (56.9%) | |
Increase in oral transit time | |||
Yes | 4 (6.9%) | 44 (75.9%) | < 0.001*1 |
Not | 54 (93.1%) | 14 (24.1%) | |
Food stasis in the oral cavity | |||
Yes | 2 (3.4%) | 41 (70.7%) | < 0.001 |
Not | 56 (96.6%) | 17 (29.3%) | |
Difficulties in the chewing process | |||
Yes | 1 (1.7%) | 21 (36.2%) | < 0.001 |
No | 49 (84.5%) | 22 (37.9%) | |
No applicable | 8 (13.8%) | 15 (25.9%) | |
Cough | |||
Yes | 3 (5.2%) | 7 (12.1%) | 0.001 |
Not | 55 (94.8%) | 51 (89.9%) | |
Choking | |||
Yes | 2 (3.4%) | 7 (12.1%) | 0.078 |
Not | 56 (96.6%) | 51 (87.9%) | |
Changes in the respiratory pattern | |||
Yes | 1 (1.7%) | 12 (20.7%) | < 0.001*1 |
Not | 57 (94.8%) | 46 (79.3%) | |
Decrease laryngeal elevation | |||
Yes | – | 18 (31%) | < 0.001*1 |
Not | 58 (100%) | 40 (69%) | |
Increased pharyngeal transit time | |||
Yes | 3 (5.2%) | 12 (20.7%) | < 0.001*1 |
Not | 55 (94.8%) | 46 (79.3%) | |
OPD in CSA | |||
Absent | 53 (91.4%) | 12 (20.7%) | < 0.001*1 |
Present | 5 (8.6%) | 46 (79.3%) | |
Classification of dysphagia | |||
Normal swallowing | 53 (91.4%) | 12 (20.7%) | < 0.001*1 |
Mild dysphagia | 3 (5.2%) | 12 (20.7%) | |
Moderate/severe dysphagia | 2 (3.4%) | 34 (58.4%) |