Children Born With Congenital Zika Syndrome Display Atypical Gross Motor Development and a Higher Risk for Cerebral Palsy

Abstract

Importance: Congenital Zika syndrome virus infection is said to interfere in children's development. Objective: evaluate gross motor trajectories and the frequency of cerebral palsy in children with congenital Zika syndrome. Design: Cohort study applying the Alberta Infant Motor Scale (AIMS) and the Bayley III Scales in infants from 6 to 18 months of age. Setting: The SARAH network, Rio de Janeiro. Participants: Thirty-nine infants whose diagnoses were established through clinical history, serology tests, and neuroimaging findings. Main outcomes and measures: Congenital Zika syndrome is associated with severe motor delays and is a risk factor to the diagnosis of cerebral palsy. Results: The Alberta Infant Motor Scale mean raw score at 6 months was 9.74 (SD 4.80) or equivalent to 2 to 3 months of motor developmental age. At the age of 12 months, 14.13 (SD 11.90), corresponding to 3 to 4 months of motor development age; the Bayley III Scales results correlated to the Alberta Infant Motor Scale (P < .001) at this age. At 18 months, 15.77 (SD 13.80) or a motor development equivalent to 4 to 5 months of age. Thirty-five of 39 children (89.7%) met criteria for the diagnosis of cerebral palsy. Conclusions and relevance: Gross motor development marginally progresses from 6 to 18 months of age. These individuals also displayed a high frequency of cerebral palsy.

Neurodevelopment of Nonmicrocephalic Children, After 18 Months of Life, Exposed Prenatally to Zika Virus

“…The resulting neurologic phenotype is characterized by hypertonicity, clonus, hyperreflexia, abnormal movements, spasticity, contractures, seizures, and cognitive impairment. 3,4,6…”

Neurocognitive impacts of arbovirus infections

“…Importantly, there are now follow-up studies showing the effects from ZIKV-associated brain malformations or subtler damages. Such studies in infants with CZS confirmed strong neurological disabilities, in particular ocular and motor impairment, as well as epileptic manifestation [48,[55][56][57][58][59][60]. A study assessed over 1400 children of at least 1 year of age born from ZIKV-infected mothers and showed important rates of neurodevelopmental defects (up to 14% with seizure or, neurodevelopmental delays) [61].…”

Congenital Zika Syndrome—Assessing the Need for a Family Support Programme in Brazil

“…The evidence on CZS that was emerging at the time of this study highlighted the similarities of the physical presentation of CZS to those of CP. More recent literature has further described the overlapping between CZS and CP [35][36][37]. The review of the literature and findings of the social and economic impact study also suggested that there are similarities between CP and CZS, particularly in terms of needs and unmet needs of the caregiver.…”