Quintans Maria D S, Vianna Renata A de O, Velarde Luis G C, de Oliveira Solange A, Fernandes Alexandre R, Bueno Arnaldo C, Cardoso Claudete A A
From the Maternal and Child Department, School of Medicine, Universidade Federal Fluminense.
Department of Statistics, Universidade Federal Fluminense.
Pediatr Infect Dis J. 2025 Feb 1;44(2):154-160. doi: 10.1097/INF.0000000000004534. Epub 2024 Sep 12.
To monitor by the first 24 months of life, children born to mothers with laboratory evidence of chikungunya virus (CHIKV) infection during pregnancy or up to 8 weeks before it, and to describe abnormalities in head circumference (HC), auditory and ophthalmological assessments and neuroimaging tests during the follow-up period.
This is a observational, descriptive, longitudinal and prospective study of children born to mothers who had a rash and a positive test for CHIKV during pregnancy or up to 8 weeks before it. They were admitted between November 2015 and May 2019 in the outpatient multidisciplinary clinic to investigate acute exanthematous disease. The exposed children were followed up by a multidisciplinary team and underwent periodic measurements of the HC. The Denver II test was applied, in addition to transfontanellar ultrasound (TU) to evaluate neurodevelopmental outcomes during the study period. Ophthalmological and auditory examinations, echocardiography and laboratory tests were also included.
We included in the study 27 children vertically exposed to CHIKV. All children had a negative polymerase chain reaction test for the virus collected at the first outpatient visit (mean age of 16.8 days and standard deviation of 8 days). No clinical condition compatible with congenital infection at birth was reported. A change in HC characterized by macrocephaly and mild global delay development was observed in a 1-year-old child whose mother was infected in the peripartum, but with normal TU. Changes in the TU were observed in 2 other children with nonspecific subependymal cystic malformation that was not evident by the cranial computed tomography. The other children monitored showed normal results in the Denver II test, in the HC and TU. No changes were identified on ocular ophthalmoscopy or auditory brainstem response test. Two children had an increase in serum ferritin levels during the first year of life, with the others' inflammatory disease markers normal.
Our study added knowledge about the neurodevelopment of children exposed to CHIKV during pregnancy by a longitudinal and prospective follow-up, throughout their first 24 months of life. We did not observe a negative impact of exposure to the virus on the neurological examination, global developmental test or measurements of the HC of these children.
对孕期或妊娠前8周内有实验室证据表明感染基孔肯雅病毒（CHIKV）的母亲所生儿童进行24个月的监测，并描述随访期间头围（HC）、听力和眼科评估及神经影像学检查的异常情况。
这是一项对孕期或妊娠前8周内出现皮疹且CHIKV检测呈阳性的母亲所生儿童进行的观察性、描述性、纵向和前瞻性研究。2015年11月至2019年5月期间，这些儿童被收治到门诊多学科诊所，以调查急性发疹性疾病。暴露儿童由多学科团队进行随访，并定期测量头围。在研究期间，除经囟门超声（TU）外，还应用了丹佛发育筛查测验第二版（Denver II）来评估神经发育结果。还包括眼科和听力检查、超声心动图检查及实验室检查。
我们纳入了27例垂直感染CHIKV的儿童。所有儿童在首次门诊就诊时采集的病毒聚合酶链反应检测均为阴性（平均年龄16.8天，标准差8天）。未报告出生时符合先天性感染的临床情况。在一名母亲在围产期感染的1岁儿童中观察到头围变化，其特征为巨头畸形和轻度整体发育延迟，但经囟门超声检查正常。在另外2名儿童中观察到经囟门超声检查有变化，表现为非特异性室管膜下囊性畸形，头颅计算机断层扫描未显示明显异常。其他接受监测的儿童在丹佛发育筛查测验第二版、头围和经囟门超声检查中结果正常。眼科检眼镜检查或听觉脑干反应测试未发现变化。2名儿童在出生后第一年血清铁蛋白水平升高，其他儿童的炎症性疾病标志物正常。
我们的研究通过对孕期暴露于CHIKV的儿童在其生命的前24个月进行纵向和前瞻性随访，增加了对其神经发育的了解。我们未观察到病毒暴露对这些儿童的神经学检查、整体发育测试或头围测量有负面影响。
