Familiar Itziar, Boivin Michael, Magen Jed, Azcorra Jose Antonio, Phippen Colton, Barrett Elizabeth Ann, Miller Sydney, Ruisenor-Escudero Horacio
Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA.
Department of Psychiatry and Department of Neurology and Ophthalmology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA.
Child Care Health Dev. 2021 May;47(3):311-318. doi: 10.1111/cch.12842. Epub 2020 Dec 28.
Few studies have assessed neurodevelopmental outcomes in normocephalic infants born to women with Zika virus (ZIKV) infection during pregnancy in Mexico. We sought to evaluate ZIKV exposed infants in Yucatan, Mexico, with performance-based and eye-gaze measures of neurodevelopment, removing observer bias.
We enrolled 60 infants about 6-month old born to women with PCR + test for ZIKV during pregnancy. Infants were normocephalic and asymptomatic. Sixty infants born to women without a history of ZIKV infection were included as comparison. Children were assessed with the Mullen scales of early learning (MSEL), a test with scales in motor, language, and overall cognitive skills development, and the Fagan test of infant intelligence (FTII) using automated eye-tracking instrumentation to evaluate infant visual preference of human faces, where longer gaze lengths to unfamiliar (i.e., new) faces are expected.
All MSEL subscale scores, except expressive language, were significantly lower among ZIKV exposed children compared to controls, including the overall standard composite (80 ± 10 vs. 87 ± 7.4, respectively; p < 0.001). FTII eye-tracking measures of fixation and gaze length were in the expected direction, with longer times recorded among infants in the control group (i.e., higher attention), but none reached statistical significance. In adjusted linear regressions, the FTII high novelty score (expected preference for a novel face) predicted fine motor (β = 3.61, p = 0.04) and receptive language (β = 2.55, p = 0.03) scores.
Nonmicrocephalic children born to women with ZIKV during pregnancy in Mexico merit early neurodevelopmental evaluation to allow for appropriate interventions and clinical follow-up. It is possible that long-term monitoring of cognitive deficits may need to be established for a proportion of affected cases.
在墨西哥，很少有研究评估孕期感染寨卡病毒（ZIKV）的女性所分娩的头围正常婴儿的神经发育结局。我们试图在墨西哥尤卡坦州，采用基于表现和眼动注视的神经发育测量方法，对暴露于ZIKV的婴儿进行评估，以消除观察者偏差。
我们纳入了60名约6个月大、母亲孕期ZIKV PCR检测呈阳性的婴儿。这些婴儿头围正常且无症状。另外纳入60名母亲无ZIKV感染史的婴儿作为对照。使用早期学习的莫伦量表（MSEL）对儿童进行评估，该测试包括运动、语言和整体认知技能发展方面的量表，并使用自动眼动追踪仪器进行婴儿智力的费根测试（FTII），以评估婴儿对人脸的视觉偏好，预期对不熟悉（即新的）面孔的注视时间更长。
与对照组相比，暴露于ZIKV的儿童中，除表达性语言外，所有MSEL子量表得分均显著较低，包括总体标准综合得分（分别为80±10和87±7.4；p<0.001）。FTII的注视和注视时间的眼动追踪测量结果符合预期方向，对照组婴儿的记录时间更长（即注意力更高），但均未达到统计学显著性。在调整后的线性回归中，FTII的高新奇度得分（对新面孔的预期偏好）可预测精细运动（β=3.61，p=0.04）和接受性语言（β=2.55，p=0.03）得分。
在墨西哥，孕期感染ZIKV的女性所分娩的非小头畸形儿童应进行早期神经发育评估，以便进行适当的干预和临床随访。对于一部分受影响的病例，可能需要建立对认知缺陷的长期监测机制。
