{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:18:20Z","timestamp":1788412700065,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T00:00:00Z","timestamp":1570579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2019,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Paralysis of the diaphragm in newborn infants can lead to recurrent infections and life\u2010threatening respiratory insufficiency. The clinical diagnosis of unilateral diaphragmatic paralysis has been reported in infants with laboratory evidence of congenital Zika virus infection and\/or the congenital Zika syndrome (CZS) phenotype but no evaluation of phrenic nerve function has been described. All reported infants have had accompanying arthrogryposis. High infant mortality is reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The causal mechanism of congenital diaphragmatic paralysis was evaluated in three infants with arthrogryposis as a manifestation of CZS (two of the three infants had laboratory evidence of ZIKV infection shortly after birth; the remaining infant had negative serology for ZIKV when first tested at 7 months of age). Electromyography and phrenic nerve compound muscle action potential (CMAP) were performed in all infants with diaphragmatic paralysis demonstrated on imaging studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All infants had evidence of moderate chronic involvement of peripheral motor neurons. Phrenic nerve CMAP was reduced on the side of the diaphragmatic paralysis in two infants and reduced bilaterally in the remaining infant who had primarily anterior involvement of the diaphragm. All three infants had multiple medical complications and one infant died at 18\u2009months of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Evaluation of three infants with CZS and diaphragmatic paralysis demonstrated phrenic nerve dysfunction. In these and other affected infants, arthrogryposis appears to be a constant co\u2010occurring condition and health problems are significant; both conditions are likely due to involvement of the peripheral nervous system in some infants with CZS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1597","type":"journal-article","created":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T07:55:37Z","timestamp":1570607737000},"page":"1577-1583","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Diaphragmatic paralysis: Evaluation in infants with congenital Zika syndrome"],"prefix":"10.1002","volume":"111","author":[{"given":"Vanessa","family":"van der Linden","sequence":"first","affiliation":[{"name":"Association for Assistance of Disabled Children  Recife Brazil"},{"name":"Bar\u0101o de Lucena Hospital  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otavio Gomes","family":"Lins","sequence":"additional","affiliation":[{"name":"Federal University of Pernambuco  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natacha Calheiros","family":"de Lima Petribu","sequence":"additional","affiliation":[{"name":"Bar\u0101o de Lucena Hospital  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Claudia Marques Gouveia","family":"de Melo","sequence":"additional","affiliation":[{"name":"Restaura\u00e7\u00e3o Hospital  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jazmyn","family":"Moore","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja A.","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"College of Medicine, Department of Pediatrics University of Florida  Gainesville Florida"},{"name":"College of Medicine and College of Public Health and Health Professions, Department of Epidemiology University of Florida  Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4224-2692","authenticated-orcid":false,"given":"Cynthia A.","family":"Moore","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6641a1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-015-3418-5"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5125"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2012.12.011"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(79)80358-3"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2009.11.005"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.14.4.311"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950180311"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2019.06.021"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30727-2"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30902-3"},{"issue":"3","key":"e_1_2_9_13_1","first-page":"1873","article-title":"Control of breathing activity in the fetus and newborn","volume":"2","author":"Greer J. J.","year":"2012","journal-title":"Comprehensive Physiology"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420250207"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1006219"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2010.65"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases6010016"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.20887"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(18)30020-8"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.3720"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix166"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.3982"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00014-16"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2408.180057"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix374"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-46"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201501-070LE"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases6010007"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320170213"},{"issue":"2","key":"e_1_2_9_30_1","first-page":"717","article-title":"Progressive lesions of central nervous system in microcephalic fetuses with suspected congenital Zika virus syndrome","volume":"50","author":"Sarno M.","year":"2016","journal-title":"Ultrasound in Obstetrics & Gynecology"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6503e2"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016161584"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-93042016000400007"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1015-9584(09)60285-2"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3899"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(73)80339-7"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbdr2.1597","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1597","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bdr2.1597","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1597","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T12:58:15Z","timestamp":1694177895000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.1597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,9]]},"references-count":35,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2019,11,15]]}},"alternative-id":["10.1002\/bdr2.1597"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.1597","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,9]]},"assertion":[{"value":"2019-06-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}