Department of Neuroscience and Physiology and Behavioral Sciences, School of Medicine, St. George's University, St. George's, Grenada, West Indies.
Windward Islands Research and Education Foundation, St. George's, Grenada, West Indies.
PLoS Negl Trop Dis. 2020 Oct 5;14(10):e0008546. doi: 10.1371/journal.pntd.0008546. eCollection 2020 Oct.
The 2005-06 chikungunya virus (CHIKV) outbreak in La Réunion suggested that mothers could transmit CHIKV to their neonates while viremic during the intrapartum period, and more than half of the infected neonates showed impaired neurodevelopment at two years of age. However, data sparsity precluded an overview of the developmental impact of vertical infection within the whole prenatal period.
OBJECTIVE & METHODS: The current study assessed two-year old children born to mothers who were infected during the 2014 CHIKV outbreak in Grenada to determine the neurodevelopmental impact of perinatal CHIKV infection throughout gestation. Mother and child infection status were confirmed by serologic testing (IgG and IgM) for CHIKV. Cognitive, fine motor, gross motor, language and behavioral outcomes were assessed at two years of age on the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA).
No differences in neurodevelopmental outcomes were observed between two-year-old children born to mothers infected with CHIKV during gestation (n = 149) and those born to mothers not infected with CHIKV (n = 161). No differences were found in INTER-NDA scores between children infected with CHIKV (n = 47) and children not infected with CHIKV (n = 592). Likewise, there were no differences between children infected with CHIKV post-partum (n = 19) versus children not infected with CHIKV (n = 592).
Our findings suggest that children exposed and/or infected with CHIKV outside of the intrapartum period experience no significant neurodevelopmental delay at two years of age, as measured by the INTER-NDA, compared to their unexposed and/or uninfected peers. These results complement those of previous studies which showed a neurodevelopmental risk only for children infected during the intrapartum period, while the mother was highly viremic. These results might be reassuring for women of childbearing age and public health officials in CHIKV-endemic regions.
2005-06 年留尼汪岛的基孔肯雅病毒（CHIKV）疫情表明，母亲在分娩期间病毒血症期间可能将 CHIKV 传播给新生儿，而且一半以上感染的新生儿在两岁时出现神经发育受损。然而，数据的缺乏妨碍了对整个产前期间垂直感染对发育影响的全面了解。
本研究评估了在 2014 年格林纳达 CHIKV 疫情期间感染的母亲所生的两岁儿童，以确定整个孕期围产期 CHIKV 感染对神经发育的影响。通过血清学检测（IgG 和 IgM）确认母亲和儿童的 CHIKV 感染状态。在两岁时使用 INTERGROWTH-21 神经发育评估（INTER-NDA）评估认知、精细运动、粗大运动、语言和行为结果。
在孕期感染 CHIKV 的母亲所生的两岁儿童（n=149）与未感染 CHIKV 的母亲所生的儿童（n=161）之间，神经发育结果无差异。感染 CHIKV 的儿童（n=47）与未感染 CHIKV 的儿童（n=592）之间，INTER-NDA 评分也无差异。同样，产后感染 CHIKV 的儿童（n=19）与未感染 CHIKV 的儿童（n=592）之间也无差异。
我们的研究结果表明，与未暴露和/或未感染的同龄人相比，通过 INTER-NDA 测量，在围产期以外暴露和/或感染 CHIKV 的儿童在两岁时没有明显的神经发育迟缓。这些结果与之前的研究结果相补充，这些研究结果表明，只有在围产期期间母亲病毒血症水平高时感染的儿童才存在神经发育风险。这些结果可能会让育龄妇女和基孔肯雅病毒流行地区的公共卫生官员感到放心。
