Microcephaly presents complex and multifactorial etiology, detected from a screening by measuring the Head Circumference (HC) of the newborn, when there is a HC below two standard deviations from the specific mean for sex and gestational age, being considered severe, when the measurement is below three standard deviations [1-4]. Most often, the reduced head circumference is related to changes in the baby’s cognitive system and impaired Central Nervous System (CNS). However, this reduction may not cause an abnormality in brain development in some newborns with microcephaly [5]. Some congenital infectious processes may cause the development of microcephaly. Among them, the most common are: rubella, cytomegalovirus, syphilis, toxoplasmosis and herpes simplex [2,3]. Zika virus (ZIKV), an arbovirus, which presents its form of transmission by mosquitoes, was first isolated in 1947 from a female monkey from the Zika Forest in Uganda, Africa [6]. In Brazil, around one million individuals were infected with this viral infection, with the first transmission confirmed in 2015, in April. The Aedes aegypti mosquito is the main vector agent, which caused a state of public health emergency. In Brazil, after the beginning of the epidemic, there was a great increase in the number of confirmed cases of microcephaly, with 1,248 of new suspected cases of microcephaly in neonates [7]. According to the Information System on Live Births (SINASC), there were around 156 new cases of microcephaly registered annually, in the period from 2010 to 2014. However, in 2015, there were 1,248 individuals with the disease [8,9]. In the alarming scenario of the microcephaly epidemic, there was need for a greater contribution of financial investments in Brazil, with emphasis on improving the quality of life and basic sanitation of the population. Access to quality water and basic sanitation are fundamental to increase life expectancy and reduce mortality, especially maternal and child, in addition to vector control and prevention of arboviruses. Furthermore, the effective selective collection of solid waste is essential, promoting a better management of vector control and improvement of the quality of the environment [3]. In Brazil, the presence of intense structural, social and economic inequalities favour the proliferation of insects, lack of adequate structures with basic sanitation, ineffectiveness in the garbage collection process, causes further increase in the proliferation of pathologies. Therefore, it is important to develop assertive and appropriate public policies [10]. Genetic and environmental factors are among the most common causes of microcephaly. Chromosome abnormalities, multifactorial disorders, or variations in Mendelian genetics are present when associated with the genetic factor. Regarding environmental situations, they can be caused by congenital infectious processes, perinatal hypoxia, drug use, maternal phenylketonuria, and exposure of the uterus to ionizing radiation [11]. However, it is important to know studies on the association of microcephaly with Zika virus in North Eastern Brazil, especially in the Cariri region. Thus, the objective of this study is to know the factors that led to the increase in cases of microcephaly and its repercussion on mental health.

This is a cross-sectional research of quantitative-qualitative approach, delineated through descriptive study in formal statistical analysis. The study was carried out in inland Ceará in a reference unit for children with microcephaly. The participants of this research were thirteen (13) mothers with children with microcephaly who agreed to participate in the study, who lived in the Cariri Region and participated in the treatment of microcephaly in a reference polyclinic in the treatment of microcephaly, in inland Ceará, in the period from 2015 to 2016, which presented the highest number of cases of microcephaly. The quantitative results were analyzed through probabilistic approach of the sample from statistical crossings. It is worth mentioning that, initially, the data were organized in tables and graphs. The mean statistical measures, standard deviation and odds ratio were calculated with their respective 95% confidence intervals (CI95%). The means were compared, the normality of the data and the equality of variances were verified by the KolmogorovSmirnov and Levene tests, respectively. The microcephaly means were analyzed by Student’s t-test for independent data and by the F-test. In the latter, when p <0.05, multiple comparisons were made by the Tukey test (if equal variances) and by the GamesHowell test (if unequal variances).