Avaliação auditiva e do desenvolvimento da linguagem de 1 a 4 anos em nascidos expostos à Infecção Gestacional pelo Vírus Zika

Abstract

The recognized neurotropism of the Zika virus, suggests that the hearing organs and their neural pathways may be affected in prenatal infections. Among the possible manifestations are audiological and language changes, but so far, the data in the literature are inconclusive. Objectives: to verify the prevalence of early and late hearing disorders in children with Gestational Infection by Zika virus (IGVZ), to evaluate between 14 and 47 months the language development in this population and its possible correlation with the alterations found in the hearing exams. Methods: longitudinal, prospective, observational study of children born in Juiz de Fora and macro region, with confirmed diagnosis of Zika virus (VZ) infection during pregnancy. Collections between 1 and 4 years of age were programmed for hearing, with the Transient Evoked Otoacoustic Emissions (TOAE) test, Immittance test and Brainstem Evoked Response Audiometry (BERA), and language, using the Bayley Scales of Infant Development – Third Edition (Bayley-III). Results: 15 participants were included, and the vast majority were over the age of two when they performed the hearing tests. Hearing disorders were found in eight (53.33%) participants, seven (46.67%) had poor language performance in at least one of the ages assessed and one participant had early hearing loss (6%), of sensorineural origin, accompanied by low language performance. Three (20%) participants had all altered hearing tests, all with language impairment at the same age, and two (13.33%) participants with extensive malformations in the central nervous system (CNS), presented significant language delay, despite the results hearing tests are within normal limits. Considering three age groups where there was greater attendance separately, nine preschoolers were examined at 30 or 31 months, four (44.44%) of which underperformed for age on the Bayley Language Scale, four (44, 44%) with alterations in at least one hearing test and two (22.22%) with these two outcomes simultaneously. In the range of 36 to 38 months, 11 preschoolers were evaluated and three (27.27%) had alterations in at least one hearing test and none showed language impairment. At the age of 40 to 42 months, eight preschoolers were examined and two (25%) showed poor performance in language acquisition, three (37.50%) with changes in at least one of the hearing tests and one (12.50 %) had these two outcomes. Conclusion: there was a prevalence like that found in other risk conditions for early hearing loss and a high prevalence of late hearing loss, of a fluctuating character, in infants and preschoolers with IGVZ. Language development was below expectations for age when all hearing tests were suggestive of conduction hearing loss, when there was early hearing loss or in the existence of extensive CNS lesions. The results reinforce the importance of audiological examinations, especially the morphological and auditory threshold BERA, in monitoring cases of IGZV at least until the age of three.