Department of Neonatology, Instituto Fernandes Figueira, Rio de Janeiro, Brazil.
Clinical Research Unit, FIOCRUZ, Rio de Janeiro, Brazil.
Acta Paediatr. 2021 Aug;110(8):2375-2381. doi: 10.1111/apa.15878. Epub 2021 May 3.
Our aim was to analyse 12-month outcomes of children who were prenatally exposed to the Zika virus and asymptomatic at birth.
This was an observational, exploratory study of infants exposed to the Zika virus during gestation and born between March 2016 and April 2017 without congenital Zika syndrome. They were followed until the age of 22 months. The outcome measure was neurodevelopment at 12 months of life, which was evaluated with the Bayley Scales of Infant and Toddler Development, Third edition (Bayley-III). The scores were adjusted for maternal education and prematurity.
A total of 96 infants were included in the study and 35.4% scored below the normal range in at least one Bayley-III domain. The majority (91.2%) of the infants with delayed scores presented with language delay, which was not associated with the gestational age at exposure. Receptive language was more affected by exposure than expressive language (27.0% vs 19.8%). There was a direct, and significant, association between the head circumference Z-score at birth and language delay.
Language delay was associated with a smaller head circumference at birth in infants prenatally exposed to the Zika virus and born asymptomatic. This may indicate future learning difficulties.
分析在出生时无症状但存在 Zika 病毒宫内暴露的儿童在 12 个月时的结局。
这是一项对在妊娠期间暴露于 Zika 病毒且无先天性 Zika 综合征的婴儿进行的观察性探索性研究。这些婴儿出生于 2016 年 3 月至 2017 年 4 月之间，随访至 22 月龄。结局指标为 12 月龄时的神经发育情况，采用贝利婴幼儿发育量表第三版（Bayley-III）进行评估。评分经过母亲教育程度和早产情况的校正。
共有 96 名婴儿纳入研究，其中 35.4%的婴儿在至少一个 Bayley-III 领域的评分低于正常值范围。大多数（91.2%）延迟评分的婴儿存在语言延迟，而这与暴露时的胎龄无关。与表达性语言相比，接受性语言受暴露影响更大（27.0%比 19.8%）。出生时头围 Z 评分与语言延迟呈直接显著相关。
在出生时无症状但存在 Zika 病毒宫内暴露的婴儿中，语言延迟与出生时头围较小相关，这可能预示着未来存在学习困难。
