Epidemiology Directorate, Ministry of Health, Santo Domingo, Dominican Republic.
Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL.
Ann Glob Health. 2021 Jan 5;87(1):4. doi: 10.5334/aogh.3095.
When acquired during pregnancy, Zika virus (ZIKV) infection can cause substantial fetal morbidity, however, little is known about the long-term neurodevelopmental abnormalities of infants with congenital ZIKV exposure without microcephaly at birth.
We conducted a cross sectional study to characterize infants born with microcephaly, and a retrospective cohort study of infants who appeared well at birth, but had possible congenital ZIKV exposure. We analyzed data from the Dominican Ministry of Health's (MoH) National System of Epidemiological Surveillance. Neurodevelopmental abnormalities were assessed by pediatric neurologists over an 18-month period using Denver Developmental Screening Test II.
Of 800 known live births from 1,364 women with suspected or confirmed ZIKV infection during pregnancy, 87 (11%) infants had confirmed microcephaly. Mean head circumference (HC) at birth was 28.1 cm (SD ± 2.1 cm) and 41% had a HC on the zero percentile for gestational age. Of 42 infants with possible congenital ZIKV exposure followed longitudinally, 52% had neurodevelopmental abnormalities, including two cases of postnatal onset microcephaly, during follow-up. Most abnormalities resolved, though two infants (4%) had neurodevelopmental abnormalities that were likely associated with ZIKV infection and persisted through 15-18 months.
In the DR epidemic, 11% of infants born to women reported to the MoH with suspected or confirmed ZIKV during pregnancy had microcephaly. Some 4% of ZKV-exposed infants developed postnatal neurocognitive abnormalities. Monitoring of the cohort through late childhood and adolescence is needed.
母体感染寨卡病毒（ZIKV）可导致胎儿严重畸形，但对于无出生时小头畸形的先天性 ZIKV 暴露婴儿的长期神经发育异常知之甚少。
我们进行了一项横断面研究，以描述小头畸形婴儿的特征，以及一项回顾性队列研究，以描述出生时表现良好但可能存在先天性 ZIKV 暴露的婴儿。我们分析了多米尼加卫生部（MoH）国家流行病学监测系统的数据。通过儿科神经科医生使用丹佛发育筛查测试 II 在 18 个月的时间内评估神经发育异常。
在 1364 名疑似或确诊妊娠期间感染 ZIKV 的孕妇中，800 名已知活产婴儿中，87 名（11%）婴儿确诊为小头畸形。出生时平均头围（HC）为 28.1 厘米（标准差±2.1 厘米），41%的 HC 处于零胎龄百分位。42 名接受纵向随访的可能存在先天性 ZIKV 暴露的婴儿中，52%存在神经发育异常，包括 2 例产后出现的小头畸形。大多数异常得到缓解，但有 2 名婴儿（4%）存在神经发育异常，可能与 ZIKV 感染有关，并持续到 15-18 个月。
在 DR 疫情中，MoH 报告的 11%疑似或确诊妊娠期间感染 ZIKV 的孕妇所生婴儿患有小头畸形。约有 4%的 ZKV 暴露婴儿出现产后神经认知异常。需要对队列进行监测至儿童晚期和青春期。
