1. Neurodevelopment in Children Exposed to Zika Virus: What Are the Consequences for Children Who Do Not Present with Microcephaly at Birth?
- Author
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Sobral da Silva, Paula Fabiana, Eickmann, Sophie Helena, Ximenes, Ricardo Arraes de Alencar, Martelli, Celina Maria Turchi, Brickley, Elizabeth B., C. Lima, Marília, Montarroyos, Ulisses R., de Carvalho, Maria Durce Costa Gomes, Rodrigues, Laura Cunha, de Araújo, Thalia Velho Barreto, Ventura, Liana O., da Silva Oliveira, Danielle Maria, Ferreira Ramos, Regina Coeli, Miranda-Filho, Demócrito de Barros, and on behalf of the Microcephaly Epidemic Research Group (MERG)
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Microcephaly ,Developmental Disabilities ,Bayley scales ,Neurological examination ,Bayley Scales of Infant Development ,Microbiology ,Language Development ,Article ,Zika virus ,03 medical and health sciences ,0302 clinical medicine ,Cognition ,Pregnancy ,Virology ,medicine ,neuroclinical examination ,Humans ,030212 general & internal medicine ,Toddler ,Pregnancy Complications, Infectious ,child development ,biology ,medicine.diagnostic_test ,business.industry ,Zika Virus Infection ,paediatric cohort ,congenital Zika ,medicine.disease ,biology.organism_classification ,Child development ,QR1-502 ,Infectious Diseases ,Cross-Sectional Studies ,Motor Skills ,Child, Preschool ,Prenatal Exposure Delayed Effects ,Female ,business ,030217 neurology & neurosurgery - Abstract
The relation of Zika virus (ZIKV) with microcephaly is well established. However, knowledge is lacking on later developmental outcomes in children with evidence of maternal ZIKV infection during pregnancy born without microcephaly. The objective of this analysis is to investigate the impact of prenatal exposure to ZIKV on neuropsychomotor development in children without microcephaly. We evaluated 274 children including 235 ZIKV exposed and 39 controls using the Bayley-III Scales of Infant and Toddler Development (BSIDIII) and neurological examination. We observed a difference in cognition with a borderline p-value (p = 0.052): 9.4% of exposed children and none of the unexposed control group had mild to moderate delays. The prevalence of delays in the language and motor domains did not differ significantly between ZIKV-exposed and unexposed children (language: 12.3% versus 12.8%, motor: 4.7% versus 2.6%). Notably, neurological examination results were predictive of neurodevelopmental delays in the BSIDIII assessments for exposed children: 46.7% of children with abnormalities on clinical neurological examination presented with delay in contrast to 17.8% among exposed children without apparent neurological abnormalities (p = 0.001). Overall, our findings suggest that relative to their unexposed peers, ZIKV-exposed children without microcephaly are not at considerably increased risk of neurodevelopmental impairment in the first 42 months of life, although a small group of children demonstrated higher frequencies of cognitive delay. It is important to highlight that in the group of exposed children, an abnormal neuroclinical examination may be a predictor of developmental delay. The article contributes to practical guidance and advances our knowledge about congenital Zika.
- Published
- 2021