Neurological growth and development of children asymptomatic at birth whose mothers had Zika during pregnancy

Abstract

Introduction: Newborn who had Zika vírus but did not show microcephaly at birth may have neuropsychomotor development problems. We aimed to evaluate the developmental and anthropometric milestones of asymptomatic children whose mothers had Zika during pregnancy in Northeastern Brazil in 2015 and 2016. Methods: We conducted a descriptive cross-sectional case series study of children in Fortaleza born without microcephaly whose mothers had Zika during pregnancy. Home visits were undertaken to evaluate the developmental milestones and gather anthropometric data of the children and to conduct semi-structured interviews with the mothers to identify their socioeconomic and gestational profiles and assess the newborns after birth. Results: In total, 30 cases were identified. Of these, 17 children and their mothers participated in the study. The median age of the mothers at the time of delivery was 26 years. All were symptomatic, and TORCH was negative. At the time of the home visit, all had growth profiles suitable for their age. However, nearly all children (15/17, 88.2%) presented at least one developmental delay, considering their age group. Conclusions: There were late changes in the neuropsychomotor development of children born to mothers who had Zika during pregnancy, suggesting the need for specialized medical follow-ups.

Neurodevelopment in Normocephalic Children Exposed to Zika Virus in Utero with No Observable Defects at Birth: A Systematic Review with Meta-Analysis

“…One additional article was identified through reviewing the references of included studies. After the removal of 246 duplicates, 22 of the 566 articles included in the title–abstract screening were included in the review [ 2 , 7 , 8 , 10 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. No full texts were excluded.…”

“…Although there were differences in the description of the study populations across articles, all children included in the systematic review were normocephalic, without any apparent ZIKV clinical anomalies either screened or detected at birth (abnormal brain imaging, including structural and nonstructural abnormalities, calcifications and cysts, was detected in children from two studies). The included articles used data from retrospective ( n = 4) [ 2 , 7 , 23 , 24 ], and prospective ( n = 10) cohort studies [ 8 , 10 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], cross-sectional ( n = 4) [ 33 , 34 , 35 , 36 ], and case series ( n = 4) [ 36 , 37 , 38 , 39 ]. The median age of neurodevelopment assessment was 14 months, and four studies included assessments more than once during children development [ 23 , 24 , 31 , 37 ].…”

“…Maternal ZIKV status ascertainment included: RT-PCR [ 10 , 24 , 25 , 26 , 27 , 28 , 29 , 32 , 33 , 34 , 36 , 37 , 38 , 39 ], RT-PCR or serological tests [ 2 , 7 , 23 , 30 , 31 , 35 , 40 ], and serology [ 8 ]. RT-PCR (14 articles) [ 10 , 24 , 25 , 26 , 27 , 28 , 29 , 32 , 33 , 34 , 36 , 37 , 38 , 39 ]; laboratory confirmed and probable (e.g., symptomatic during outbreak) cases (7 articles) [ 2 , 7 , 23 , 30 , 31 , 35 , 40 ], and probable cases, by positive anti-ZIKV IgG at delivery (1 article) [ 8 ]. Some articles reported data on symptomatic pregnant women, who usually reported a rash (8 articles) [ 2 , 10 , 24 , 25 , 26 , 30 , 31 , …”

“…RT-PCR (14 articles) [ 10 , 24 , 25 , 26 , 27 , 28 , 29 , 32 , 33 , 34 , 36 , 37 , 38 , 39 ]; laboratory confirmed and probable (e.g., symptomatic during outbreak) cases (7 articles) [ 2 , 7 , 23 , 30 , 31 , 35 , 40 ], and probable cases, by positive anti-ZIKV IgG at delivery (1 article) [ 8 ]. Some articles reported data on symptomatic pregnant women, who usually reported a rash (8 articles) [ 2 , 10 , 24 , 25 , 26 , 30 , 31 , 36 ], while others included pregnant women with a laboratory confirmed infection, irrespective of symptoms. Seven articles included control groups of ZIKV unexposed children [ 25 , 28 , 29 , 31 , 33 , 34 , 35 ].…”

“…Eight articles reported data on testing for other congenital infections in maternal or neonatal samples [ 23 , 27 , 31 , 33 , 36 , 37 , 39 ]. Eleven articles reported data on the socio-economic characteristics of the families included in the studies [ 8 , 24 , 28 , 29 , 31 , 33 , 35 , 36 , 37 , 40 ]. There were differences in the way studies reported socio-demographic data.…”