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Neurodevelopment in Children Exposed to Zika Virus: What Are the Consequences for Children Who Do Not Present with Microcephaly at Birth?

1
Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife 50100-010, Brazil
2
Departamento de Neurologia Infantil, Hospital Universitário Oswaldo Cruz, Recife 50100-130, Brazil
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Departamento de Pediatria, Universidade Federal de Pernambuco, Recife 50670-420, Brazil
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Instituto Aggeu Magalhães—Fundação Oswaldo Cruz (Fiocruz), Recife 50740-465, Brazil
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Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
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Departamento de Medicina Social, Universidade Federal de Pernambuco, Recife 50670-420, Brazil
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Departamento de Oftalmologia, Fundação Altino Ventura, Recife 52171-011, Brazil
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Departamento de Infectologia Pediátrica, Hospital Universitário Oswaldo Cruz, Recife 50100-130, Brazil
*
Author to whom correspondence should be addressed.
Membership of the Microcephaly Epidemic Research Group is provided in the acknowledgments.
Academic Editors: Emma Mohr and Regina Rowe
Viruses 2021, 13(8), 1427; https://doi.org/10.3390/v13081427
Received: 31 May 2021 / Revised: 5 July 2021 / Accepted: 15 July 2021 / Published: 22 July 2021
(This article belongs to the Special Issue Pediatric Viral Infection Long-Term Consequences)
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 (p = 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 (p = 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. View Full-Text
Keywords: child development; congenital Zika; Bayley scales; paediatric cohort; neuroclinical examination child development; congenital Zika; Bayley scales; paediatric cohort; neuroclinical examination
MDPI and ACS Style

Sobral da Silva, P.F.; Eickmann, S.H.; Ximenes, R.A.d.A.; Martelli, C.M.T.; Brickley, E.B.; C. Lima, M.; Montarroyos, U.R.; Carvalho, M.D.C.G.d.; Rodrigues, L.C.; Araújo, T.V.B.d.; Ventura, L.O.; da Silva Oliveira, D.M.; Ferreira Ramos, R.C.; Miranda-Filho, D.d.B.; on behalf of the Microcephaly Epidemic Research Group. Neurodevelopment in Children Exposed to Zika Virus: What Are the Consequences for Children Who Do Not Present with Microcephaly at Birth? Viruses 2021, 13, 1427. https://doi.org/10.3390/v13081427

AMA Style

Sobral da Silva PF, Eickmann SH, Ximenes RAdA, Martelli CMT, Brickley EB, C. Lima M, Montarroyos UR, Carvalho MDCGd, Rodrigues LC, Araújo TVBd, Ventura LO, da Silva Oliveira DM, Ferreira Ramos RC, Miranda-Filho DdB, on behalf of the Microcephaly Epidemic Research Group. Neurodevelopment in Children Exposed to Zika Virus: What Are the Consequences for Children Who Do Not Present with Microcephaly at Birth? Viruses. 2021; 13(8):1427. https://doi.org/10.3390/v13081427

Chicago/Turabian Style

Sobral da Silva, Paula F., Sophie H. Eickmann, Ricardo A.d.A. Ximenes, Celina M.T. Martelli, Elizabeth B. Brickley, Marília C. Lima, Ulisses R. Montarroyos, Maria D.C.G.d. Carvalho, Laura C. Rodrigues, Thalia V.B.d. Araújo, Liana O. Ventura, Danielle M. da Silva Oliveira, Regina C. Ferreira Ramos, Demócrito d.B. Miranda-Filho, and on behalf of the Microcephaly Epidemic Research Group. 2021. "Neurodevelopment in Children Exposed to Zika Virus: What Are the Consequences for Children Who Do Not Present with Microcephaly at Birth?" Viruses 13, no. 8: 1427. https://doi.org/10.3390/v13081427

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