Malnutrition in Children with Congenital Zika Virus Syndrome: A Systematic Review

OBJECTIVE: We examined previous studies to describe growth deviations in children with Congenital Zika virus Syndrome (CZS), and to determine the factors associated with malnutrition. STUDY DESIGN: Protocol of systematic review registered on the PROSPERO platform under code CRD42023460505. The searches were conducted in SciELO, LILACS, Embase, Scopus, and PubMed/MEDLINE databases, as well as in dissertation and thesis repositories. The eligibility criteria required that the publications must be observational, cross-sectional, cohort, or case-control studies conducted with children with microcephaly associated with CZS, which presented results (z-score) of anthropometric indices of weight-for-age, height-for-age, weight-for-height, and/or body mass index (BMI)-for-age; written in English, Portuguese, or Spanish; and published between 2010 and 2023. The z-score values ​​from anthropometric indices and the factors associated with malnutrition (wasting, underweight, overweight, or stunting) were extracted. RESULTS: Eleven studies met our inclusion criteria. In these studies, children's ages ranged from 0 to 48 months. Malnutrition was identified as stunting (14.3% to 57.1%), underweight (14.3% to 54.4%), wasting (4.3% to 48.0%), and, to a lesser extent, as overweight (4.6% to 68.6%). The association of these indices was examined in relation to dysphagia, absence or duration of breastfeeding, delayed introduction of complementary feeding, consumption of ultra-processed foods, and feeding route. CONCLUSION: It was possible to identify short stature, wasting, excess weight, and inappropriate eating practices in children with CZS.