Pinho de Almeida Di Maio Ferreira Fátima Cristiane, Nielsen-Saines Karin, Lopes Moreira Maria Elisabeth, Dessimoni Salgado Aline, Pereira Costa Roozemeria, de Campos Simone B, Zhang Dajie, Hüning Britta, Einspieler Christa, Marschik Peter B, Fuller Trevon, Brasil Patricia
Department of Neonatal Intensive Care, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
J Pediatr. 2025 Apr;279:114477. doi: 10.1016/j.jpeds.2025.114477. Epub 2025 Jan 27.
To investigate the effects of intrauterine and perinatal exposure to chikungunya virus (CHIKV) on neurodevelopment in infants and toddlers.
We conducted a cohort study comparing children with intrauterine or perinatal exposure to maternal CHIKV infection with unexposed controls in Rio de Janeiro, Brazil. Neurodevelopment was assessed with General Movement Assessments in the first 6 months of life, and the Bayley-III Scales of Infant and Toddler Development and Modified Checklist for Autism in Toddlers for older children. Developmental delay (DD) was defined as a Bayley score less than 70 and risk of DD as a score less than 85.
Among 60 children exposed to intrauterine or perinatal CHIKV, 20 (33%) had laboratory confirmation of CHIKV infection by reverse transcription polymerase chain reaction or immunoglobulin M serology and 40 did not; 44 exposed children (15 infected and 29 uninfected) had General Movement Assessment performed, with 19% having suboptimal or abnormal results. At 11-42 months of age, 35 exposed children and 78 unexposed controls had Bayley-III assessments. Compared with controls, exposed children had higher rates of DD (7 [20%] vs 2 [3%], P = .004) driven by the language domain, and greater risk of DD driven by motor and cognitive domains scores (10 [29%] vs 10 [13%], P = .03 and 8 [23%] vs 5 [6%], P = .02, respectively). Eight of 35 (23%), CHIKV exposed children screened positive for autism spectrum disorder. CHIKV-exposed uninfected children had 2 (9.5%) cases of DD and 5 (23.8%) cases of autism spectrum disorder.
Abnormal neurodevelopmental results were seen in both infected and uninfected children with intrauterine or perinatal CHIKV exposure. Infant neurodevelopment monitoring should be considered following exposure to maternal CHIKV infection in pregnancy to facilitate early interventions and to mitigate neurodevelopmental sequelae.
探讨子宫内及围产期暴露于基孔肯雅病毒（CHIKV）对婴幼儿神经发育的影响。
我们在巴西里约热内卢开展了一项队列研究，比较子宫内或围产期暴露于母亲CHIKV感染的儿童与未暴露的对照儿童。在出生后的前6个月，通过全身运动评估对神经发育进行评估，对于年龄较大的儿童，则使用贝利婴幼儿发展量表第三版（Bayley-III）和幼儿自闭症改良检查表进行评估。发育迟缓（DD）定义为贝利评分低于70分，发育迟缓风险定义为评分低于85分。
在60名子宫内或围产期暴露于CHIKV的儿童中，20名（33%）通过逆转录聚合酶链反应或免疫球蛋白M血清学检测确诊感染CHIKV，40名未感染；44名暴露儿童（15名感染，29名未感染）进行了全身运动评估，其中19%的结果欠佳或异常。在11至42个月大时，35名暴露儿童和78名未暴露对照儿童接受了贝利-III评估。与对照组相比，暴露儿童在语言领域的发育迟缓发生率更高（7例[20%]对2例[3%]，P = 0.004），在运动和认知领域评分方面发育迟缓风险更高（分别为10例[29%]对10例[13%]，P = 0.03；8例[23%]对5例[6%]，P = 0.02）。35名暴露于CHIKV的儿童中有8名（23%）自闭症谱系障碍筛查呈阳性。暴露于CHIKV但未感染的儿童中有2例（9.5%）出现发育迟缓，5例（23.8%）患有自闭症谱系障碍。
在子宫内或围产期暴露于CHIKV的感染和未感染儿童中均观察到神经发育异常结果。孕期母亲感染CHIKV后，应考虑对婴儿进行神经发育监测，以便于早期干预并减轻神经发育后遗症。
