Neurodevelopment of children exposed intra-uterus by Zika virus: A case series

Abstract

The main goal of this manuscript was to investigate the neurodevelopment of children exposed by Zika virus in the intrauterine period who are asymptomatic at birth. Newborns with documented Zika virus exposure during the intrauterine period who were asymptomatic at birth were followed in the first two years of life for neurodevelopment using Bayley III test. Children were classified as having normal or delayed neurodevelopment for age based on most recent Bayley III evaluation results. Eighty-four infants were included in the study. The first Bayley III evaluation was performed at a mean chronological age of 9.7±3.1 month; 13 children (15%) had a delay in one of the three domains, distributed as follow: 10 (12%) in the language domain and 3 (3.5%) in the motor domain. The most recent Bayley III evaluation was performed at a mean age 15.3±3.1 months; 42 children (50%) had a delay in one of the three domains: 4 (5%) in cognition, 31 (37%) in language, and 20 (24%) in motor performance. There were no statistical differences in Gender, Gestational Age, Birth Weight and Head Circurference at birth between children with normal and delayed neurodevelopment for age. A very high proportion of children exposed ZIKV during pregnancy who were asymptomatic at birth demonstrated a delay in neurodevelopment, mainly in the language domain, the first two years of life.

Quantitative definition of neurobehavior, vision, hearing and brain volumes in macaques congenitally exposed to Zika virus

“…Twenty-eight percent of ZIKV-exposed children are asymptomatic at birth and present with neurodevelopmental deficits in early childhood [1][2][3][4]. These neurodevelopmental abnormalities include delays in gross motor, fine motor, and problem-solving skills [3,5,6] along with diminished mobility, communication, and social cognition [4,5]. There are currently no tools to distinguish the infants that will develop neurodevelopmental deficiencies from those who will remain asymptomatic, as the long-term outcomes in children who were born during the 2015-2016 ZIKV epidemic remain to be fully defined [3,4,[6][7][8].…”

Neurological Findings in Children without Congenital Microcephaly Exposed to Zika Virus in Utero: A Case Series Study

“…The lack of a reliable control group (one in which children had not been exposed to ZIKV) in these studies is a limitation for establishing the risk to the population, and it cannot confirm that these results would be different in the non-exposed population. The accuracy of the tests is impaired by the possibility of cross-reaction with antibodies against dengue and the fact that 50% of mothers may present asymptomatic cases not diagnosed in pregnancy [ 11 ].…”

“…The examination was performed in the Central Laboratory of Public Health (LACEN) in Manaus, according to the protocol of Lanciotti et al (2008) [ 19 ]. Considering the great possibility of cross reaction between flavivirus antibodies and the high endemicity of dengue in Brazil, in addition to avoiding invasive procedures in children, research on the serological status was not used in the methodology of this study [ 11 ]. The prenatal history of the child was obtained through interviews with the mothers and through secondary data collected from the woman’s pregnancy medical card and records from the electronic medical record at the hospital, which contain the results of serologies performed during routine prenatal control.…”

“…Although the most severe cases of central nervous system involvement are already well known, the phenotypic spectrum of congenital Zika virus syndrome (CZVS) has not been fully defined and less severe cases have been described. [ 11 , 12 , 13 , 14 ]. Knowledge gaps are still being filled in relation to children exposed to Zika virus during the gestational period who do not present the classic outcomes of CZVS at birth.…”

Quantitative definition of neurobehavior, vision, hearing and brain volumes in macaques congenitally exposed to Zika virus

“…Twenty-eight percent of ZIKVexposed children are asymptomatic at birth and present with neurodevelopmental deficits in early childhood (1)(2)(3)(4). These neurodevelopmental abnormalities include delays in gross motor, fine motor, and problem-solving skills (3,5,6) along with diminished mobility, communication, and social cognition (4,5). There are currently no tools to distinguish the infants that will develop neurodevelopmental deficiencies from those who will remain asymptomatic, as the long-term outcomes in children who were born during the 2015-2016 ZIKV epidemic remain to be fully defined (3,4,(6)(7)(8).…”