先天性寨卡病毒感染后 36 个月的结果-美国各州。
Outcomes up to age 36 months after congenital Zika virus infection-U.S. states.
机构信息
Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
出版信息
Pediatr Res. 2024 Jan;95(2):558-565. doi: 10.1038/s41390-023-02787-9. Epub 2023 Sep 1.
BACKGROUND
To characterize neurodevelopmental abnormalities in children up to 36 months of age with congenital Zika virus exposure.
METHODS
From the U.S. Zika Pregnancy and Infant Registry, a national surveillance system to monitor pregnancies with laboratory evidence of Zika virus infection, pregnancy outcomes and presence of Zika associated birth defects (ZBD) were reported among infants with available information. Neurologic sequelae and developmental delay were reported among children with ≥1 follow-up exam after 14 days of age or with ≥1 visit with development reported, respectively.
RESULTS
Among 2248 infants, 10.1% were born preterm, and 10.5% were small-for-gestational age. Overall, 122 (5.4%) had any ZBD; 91.8% of infants had brain abnormalities or microcephaly, 23.0% had eye abnormalities, and 14.8% had both. Of 1881 children ≥1 follow-up exam reported, neurologic sequelae were more common among children with ZBD (44.6%) vs. without ZBD (1.5%). Of children with ≥1 visit with development reported, 46.8% (51/109) of children with ZBD and 7.4% (129/1739) of children without ZBD had confirmed or possible developmental delay.
CONCLUSION
Understanding the prevalence of developmental delays and healthcare needs of children with congenital Zika virus exposure can inform health systems and planning to ensure services are available for affected families.
IMPACT
We characterize pregnancy and infant outcomes and describe neurodevelopmental abnormalities up to 36 months of age by presence of Zika associated birth defects (ZBD). Neurologic sequelae and developmental delays were common among children with ZBD. Children with ZBD had increased frequency of neurologic sequelae and developmental delay compared to children without ZBD. Longitudinal follow-up of infants with Zika virus exposure in utero is important to characterize neurodevelopmental delay not apparent in early infancy, but logistically challenging in surveillance models.
背景
描述先天性寨卡病毒感染儿童至 36 月龄时的神经发育异常。
方法
在美国寨卡妊娠和婴儿登记处，这是一个全国性监测系统，用于监测实验室证实存在寨卡病毒感染的妊娠结局以及存在寨卡相关出生缺陷（ZBD）的婴儿。在有可用信息的婴儿中报告了神经系统后遗症和发育迟缓，这些儿童在 14 天后至少有 1 次随访检查或至少有 1 次发育报告。
结果
在 2248 名婴儿中，10.1%早产，10.5%为小于胎龄儿。总体而言，122（5.4%）例有任何 ZBD；91.8%的婴儿有脑异常或小头畸形，23.0%有眼部异常，14.8%两者均有。在报告了 1881 名至少有 1 次随访检查的儿童中，ZBD 患儿的神经系统后遗症更为常见（44.6%），而无 ZBD 患儿的神经系统后遗症为 1.5%。在有至少 1 次发育报告的儿童中，有 ZBD 的儿童中 46.8%（51/109）和无 ZBD 的儿童中 7.4%（129/1739）确诊或可能有发育迟缓。
结论
了解先天性寨卡病毒感染儿童发育迟缓的流行情况和医疗需求，可以为卫生系统和规划提供信息，以确保为受影响的家庭提供服务。
意义
我们描述了寨卡相关出生缺陷（ZBD）存在时妊娠和婴儿结局，并描述了至 36 月龄时的神经发育异常。ZBD 患儿中常见神经系统后遗症和发育迟缓。与无 ZBD 的儿童相比，ZBD 儿童的神经系统后遗症和发育迟缓更为常见。在妊娠期间感染寨卡病毒的婴儿进行纵向随访对于描述早期婴儿未明显表现的神经发育迟缓很重要，但在监测模型中具有挑战性。
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