RT Journal Article
SR Electronic
T1 Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 244
OP 250
DO 10.1136/archdischild-2020-321031
VO 107
IS 3
A1 Karen Blackmon
A1 Roberta Evans
A1 Michelle Fernandes
A1 Barbara Landon
A1 Trevor Noel
A1 Calum Macpherson
A1 Nikita Cudjoe
A1 Kemi S Burgen
A1 Bianca Punch
A1 Amy Krystosik
A1 Elysse N Grossi-Soyster
A1 Angelle Desiree LaBeaud
A1 Randall Waechter
YR 2022
UL http://adc.bmj.com/content/107/3/244.abstract
AB Objective Zika virus (ZIKV) targets neural stem cells in the developing brain. However, the majority of ZIKV-exposed children are born without apparent neurological manifestations. It remains unclear if these children were protected from ZIKV neurotropism or if they harbour subtle pathology that is disruptive to brain development. We assess this by comparing neurodevelopmental outcomes in normocephalic ZIKV-exposed children relative to a parallel control group of unexposed controls.Design Cohort study.Setting Public health centres in Grenada, West Indies.Patients 384 mother–child pairs were enrolled during a period of active ZIKV transmission (April 2016–March 2017) and prospectively followed up to 30 months. Child exposure status was based on laboratory assessment of prenatal and postnatal maternal serum.Main outcome measures The INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) package and Cardiff Vision Tests, administered and scored by research staff masked to child’s exposure status.Results A total of 131 normocephalic ZIKV exposed (n=68) and unexposed (n=63) children were assessed between 22 and 30 months of age. Approximately half of these children completed vision testing. There were no group differences in sociodemographics. Deficits in visual acuity (31%) and contrast sensitivity (23%) were apparent in the ZIKV-exposed infants in the absence of cognitive, motor, language or behavioural delays.Conclusions Overall neurodevelopment is likely to be unaffected in ZIKV-exposed children with normal head circumference at birth and normal head growth in the first 2 years of life. However, the visual system may be selectively vulnerable, which indicates the need for vision testing by 3 years of age.Data are available on reasonable request. Data from this study are available upon reasonable request.