Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife 50100-010, Brazil.
Departamento de Neurologia Infantil, Hospital Universitário Oswaldo Cruz, Recife 50100-130, Brazil.
Viruses. 2021 Jul 22;13(8):1427. doi: 10.3390/v13081427.
The relation of Zika virus (ZIKV) with microcephaly is well established. However, knowledge is lacking on later developmental outcomes in children with evidence of maternal ZIKV infection during pregnancy born without microcephaly. The objective of this analysis is to investigate the impact of prenatal exposure to ZIKV on neuropsychomotor development in children without microcephaly. We evaluated 274 children including 235 ZIKV exposed and 39 controls using the Bayley-III Scales of Infant and Toddler Development (BSIDIII) and neurological examination. We observed a difference in cognition with a borderline p-value ( = 0.052): 9.4% of exposed children and none of the unexposed control group had mild to moderate delays. The prevalence of delays in the language and motor domains did not differ significantly between ZIKV-exposed and unexposed children (language: 12.3% versus 12.8%; motor: 4.7% versus 2.6%). Notably, neurological examination results were predictive of neurodevelopmental delays in the BSIDIII assessments for exposed children: 46.7% of children with abnormalities on clinical neurological examination presented with delay in contrast to 17.8% among exposed children without apparent neurological abnormalities ( = 0.001). Overall, our findings suggest that relative to their unexposed peers, ZIKV-exposed children without microcephaly are not at considerably increased risk of neurodevelopmental impairment in the first 42 months of life, although a small group of children demonstrated higher frequencies of cognitive delay. It is important to highlight that in the group of exposed children, an abnormal neuroclinical examination may be a predictor of developmental delay. The article contributes to practical guidance and advances our knowledge about congenital Zika.
寨卡病毒（ZIKV）与小头畸形的关系已得到充分证实。然而，对于在怀孕期间母体感染寨卡病毒但没有小头畸形的儿童，缺乏关于其后期发育结果的知识。本分析的目的是研究产前暴露于寨卡病毒对无小头畸形儿童神经心理运动发育的影响。我们使用贝利婴幼儿发育量表第三版（BSIDIII）和神经学检查评估了 274 名儿童，其中包括 235 名寨卡病毒暴露儿童和 39 名对照儿童。我们观察到认知方面存在差异，具有边缘显著性（ = 0.052）：9.4%的暴露儿童和无暴露对照组均有轻度至中度发育迟缓。语言和运动领域发育迟缓的发生率在寨卡病毒暴露和未暴露儿童之间无显著差异（语言：12.3%对 12.8%；运动：4.7%对 2.6%）。值得注意的是，神经学检查结果可预测 BSIDIII 评估中暴露儿童的神经发育迟缓：46.7%的临床神经检查异常的儿童存在发育迟缓，而无明显神经异常的暴露儿童中只有 17.8%存在发育迟缓（ = 0.001）。总体而言，与未暴露的同龄人相比，无小头畸形的寨卡病毒暴露儿童在生命的前 42 个月内神经发育受损的风险没有显著增加，尽管一小部分儿童的认知延迟频率较高。重要的是要强调，在暴露组儿童中，异常的神经临床检查可能是发育迟缓的预测因素。本文为临床实践提供了指导，并提高了我们对先天性寨卡病毒的认识。
