Grant Rebecca, Fléchelles Olivier, Tressières Benoît, Dialo Mama, Elenga Narcisse, Mediamolle Nicolas, Mallard Adeline, Hebert Jean-Christophe, Lachaume Noémie, Couchy Elvire, Hoen Bruno, Fontanet Arnaud
Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.
Sorbonne Université, Paris, France.
BMC Med. 2021 Jan 21;19(1):12. doi: 10.1186/s12916-020-01888-0.
In utero exposure to Zika virus (ZIKV) is known to be associated with birth defects. The impact of in utero ZIKV exposure on neurodevelopmental outcomes in early childhood remains unclear. The objective of this study was to determine the impact of in utero ZIKV exposure on neurodevelopment at 24 months of age among toddlers who were born normocephalic to women who were pregnant during the 2016 ZIKV outbreak in French territories in the Americas.
We conducted a population-based mother-child cohort study of women whose pregnancies overlapped with the 2016 ZIKV epidemic in Guadeloupe, Martinique, and French Guiana. Infants were included in this analysis if maternal ZIKV infection during pregnancy could be determined, the newborn had a gestational age ≥ 35 weeks, there were no abnormal transfontanelle cerebral ultrasound findings after delivery or no abnormal ultrasound findings on the last ultrasound performed during the third trimester of the mother's pregnancy, there was an absence of microcephaly at birth, and the parent completed the 24-month neurodevelopment assessment of the infant at 24 months (± 1 month) of age. ZIKV exposure of the toddler was determined by evidence of maternal ZIKV infection during pregnancy. Neurodevelopment assessments included the Ages and Stages Questionnaire (ASQ) for five dimensions of general development-communication, gross motor, fine motor, problem solving, and personal-social skills; the Modified Checklist for Autism on Toddlers (M-CHAT) for behavior; and the French MacArthur Inventory Scales (IFDC) for French language acquisition.
Between June 2018 and August 2019, 156 toddlers with and 79 toddlers without in utero ZIKV exposure completed neurodevelopment assessments. Twenty-four (15.4%) ZIKV-exposed toddlers and 20 (25.3%) ZIKV-unexposed toddlers had an ASQ result below the reference - 2SD cut-off (P = 0.10) for at least one of the five ASQ dimensions.
In one of the largest population-based cohorts of in utero ZIKV-exposed, normocephalic newborns to date, there were minimal differences apparent in neurodevelopment outcomes at 24 months of age compared to ZIKV-unexposed toddlers at 24 months of age.
ClinicalTrials.gov, NCT02810210 . Registered 20 June 2016.
已知子宫内感染寨卡病毒（ZIKV）与出生缺陷有关。子宫内感染寨卡病毒对幼儿期神经发育结局的影响尚不清楚。本研究的目的是确定在2016年美洲法属地区寨卡病毒疫情期间，正常头围出生的幼儿在24个月大时，子宫内感染寨卡病毒对其神经发育的影响。
我们对瓜德罗普岛、马提尼克岛和法属圭亚那2016年寨卡病毒疫情期间怀孕的妇女进行了一项基于人群的母婴队列研究。如果能确定母亲在孕期感染寨卡病毒、新生儿胎龄≥35周、出生后经囟门脑超声检查无异常或母亲孕期最后一次超声检查无异常、出生时无小头畸形且父母在婴儿24个月（±1个月）时完成了婴儿的24个月神经发育评估，则将婴儿纳入本分析。幼儿的寨卡病毒暴露情况通过母亲孕期感染寨卡病毒的证据来确定。神经发育评估包括针对一般发育五个维度（沟通、大运动、精细运动、问题解决和个人社交技能）的年龄与发育进程问卷（ASQ）；针对行为的幼儿自闭症改良筛查清单（M-CHAT）；以及针对法语习得的法国麦克阿瑟量表（IFDC）。
2018年6月至2019年8月，156名子宫内感染寨卡病毒的幼儿和79名未感染寨卡病毒的幼儿完成了神经发育评估。在ASQ五个维度中的至少一个维度上，24名（15.4%）感染寨卡病毒的幼儿和20名（25.3%）未感染寨卡病毒的幼儿的ASQ结果低于参考值-2SD临界值（P = 0.10）。
在迄今为止最大的一项基于人群的子宫内感染寨卡病毒的正常头围新生儿队列研究中，与24个月大时未感染寨卡病毒的幼儿相比，24个月大时神经发育结局的差异极小。
ClinicalTrials.gov，NCT02810210。2016年6月20日注册。
