Association between confirmed congenital Zika infection at birth and outcomes up to 3 years of life

Najeh Hcini,Zo Hasina Linah Rafalimanana,Léo Pomar,David Baud,Yaovi Kugbe,Alice Panchaud,Gabriel Carles,Meredith Mathieu,Véronique Lambert

doi:10.1038/s41467-021-23468-3

Abstract

Little is known about the long-term neurological development of children diagnosed with congenital Zika infection at birth. Here, we report the imaging and clinical outcomes up to three years of life of a cohort of 129 children exposed to Zika virus in utero. Eighteen of them (14%) had a laboratory confirmed congenital Zika infection at birth. Infected neonates have a higher risk of adverse neonatal and early infantile outcomes (death, structural brain anomalies or neurologic symptoms) than those who tested negative: 8/18 (44%) vs 4/111 (4%), aRR 10.1 [3.5–29.0]. Neurological impairment, neurosensory alterations or delays in motor acquisition are more common in infants with a congenital Zika infection at birth: 6/15 (40%) vs 5/96 (5%), aRR 6.7 [2.2–20.0]. Finally, infected children also have an increased risk of subspecialty referral for suspected neurodevelopmental delay by three years of life: 7/11 (64%) vs 7/51 (14%), aRR 4.4 [1.9–10.1]. Infected infants without structural brain anomalies also appear to have an increased risk, although to a lesser extent, of neurological abnormalities. It seems paramount to offer systematic testing for congenital ZIKV infection in cases of in utero exposure and adapt counseling based on these results.

Highlights

Little is known about the long-term neurological development of children diagnosed with congenital Zika infection at birth
Infants included in these cohorts were mostly affected by congenital Zika Syndrome (CZS) with cerebral anomalies or neurological impairments at birth
Among 129 children tested for ZIKV at birth, 18 (14.0%) had a laboratoryconfirmed congenital infection and 111 (86.0%) tested negative

Summary

Introduction

Little is known about the long-term neurological development of children diagnosed with congenital Zika infection at birth. Long-term disabilities, including cerebral palsy, epilepsy, and neurosensory alterations have been described in infants from the American and Brazilian cohorts[6,7,8,9] Infants included in these cohorts were mostly affected by congenital Zika Syndrome (CZS) with cerebral anomalies or neurological impairments at birth. The evolution of those with a laboratory-confirmed congenital infection but who were asymptomatic and without cerebral anomalies at birth remains poorly described. Using a subset of these infants, we show that those with a laboratory-confirmed congenital Zika infection at birth have higher risks of imaging and clinical adverse outcomes at 2 months, 2 years, and 3 years of life than those tested negative at birth

Methods

Results

Conclusion