Rose Charles E, Bertolli Jeanne, Attell Jacob Elijah, Moore Cynthia A, Melo Flavio, Kotzky Kim, Krishna Nevin, Satterfield-Nash Ashley, Pereira Isabela Ornelas, Pessoa Andre, Smith Donna Camille, Santelli Ana Carolina Faria E Silva, Peacock Georgina
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329-4027, USA.
Division of Human Development and Disability, CDC, Atlanta, GA 30329-4027, USA.
Trop Med Infect Dis. 2020 Oct 1;5(4):155. doi: 10.3390/tropicalmed5040155.
Identifying infants with congenital infection for early intervention will likely be challenging in future Zika virus outbreaks. We investigated indicators of risk for developmental delay among children born with and without obvious manifestations of congenital Zika virus infection.
We evaluated 120 children conceived during the 2015-2016 Zika virus outbreak in Paraíba, Brazil. We analyzed data from children at birth; ages 1-7 months and approximately 24 months, using medical records (i.e., anthropometric measurements diagnoses), medical evaluation (i.e., Zika/other laboratory tests, dysmorphic features), and parent report (seizures, developmental delay). We used a Bayesian modeling approach to identify predictors of developmental delay.
Head circumference (HC) and length at birth and rates of growth for HC and length at follow-up were consistent across domains of developmental delay; (e.g., for every 1 cm per month decrease in HC growth rate; there was a corresponding decrease in the gross motor z-score). Modeling results indicated that HC and length at birth, and follow-up HC and length rates of growth, were predictive of developmental delay.
These findings suggest that accurate measurement and frequent monitoring of HC and length, especially in the first few months of life, may be useful for identifying children possibly congenitally exposed to Zika virus who could benefit from early intervention services.
在未来的寨卡病毒疫情中，识别患有先天性感染的婴儿以便进行早期干预可能具有挑战性。我们调查了出生时有无先天性寨卡病毒感染明显表现的儿童发育迟缓风险指标。
我们评估了在巴西帕拉伊巴2015 - 2016年寨卡病毒疫情期间受孕的120名儿童。我们分析了这些儿童出生时、1 - 7个月大以及大约24个月大时的数据，使用病历（即人体测量诊断）、医学评估（即寨卡病毒/其他实验室检查、畸形特征）以及家长报告（癫痫发作、发育迟缓）。我们采用贝叶斯建模方法来识别发育迟缓的预测因素。
头围（HC）、出生时身长以及随访期间HC和身长的生长速率在发育迟缓的各个领域是一致的；（例如，HC生长速率每月每降低1厘米，粗大运动z评分相应降低）。建模结果表明，出生时的HC和身长以及随访时HC和身长的生长速率可预测发育迟缓。
这些发现表明，准确测量并频繁监测HC和身长，尤其是在生命的最初几个月，可能有助于识别可能先天性接触寨卡病毒且能从早期干预服务中受益的儿童。
