Abstract
Existing research has established a causal link between Zika virus (ZIKV) infection and severe birth defects or consequent health impairments; however, more subtle cognitive impairments have not been explored. To determine whether infants of mothers with at least 1 positive ZIKV test show differences in cognitive scores at ages 3 to 6 months and ages 9 to 12 months. This cross-sectional study recruited infants enrolled in existing ZIKV study cohorts associated with the Maternal-Infant Studies Center and the Puerto Rico Clinical and Translational Research Consortium at the University of Puerto Rico and from the broader San Juan metropolitan area. The study took place at the Puerto Rico Clinical and Translational Research Consortium at the University of Puerto Rico. Participants were recruited through convenience sampling if their mothers underwent ZIKV testing prenatally and were at the target ages during the study period. Infants who were born preterm (<36 weeks' gestational age), with low birth weight (<2500 g), or with a known genetic disorder were excluded. Infants were tested from ages 3 to 6 months or ages 9 to 12 months from May 2018 to April 2019. Data analysis was performed from March to April 2019. Zika virus status was measured prenatally and in the early postnatal period using real-time polymerase chain reaction or a ZIKV IgM antibody capture enzyme-linked immunosorbent assay. The infants' development was assessed using the Mullen Scales of Early Learning (translated to Spanish and adapted for Puerto Rico), and assessors were blinded to each infant's ZIKV status. A total of 65 study participants were included. The mean (SD) age of the infants at the time of cognitive testing was 8.98 (3.19) months. Most of the infants were white (55 [84.6%]) and Puerto Rican (64 [98.5%]); 38 of the infants were male (58.5%). General cognitive and domain-specific scores did not differ significantly between prenatally ZIKV-positive and ZIKV-negative infants except for receptive language score (mean difference = 5.52; t = 2.10; P = .04). Exposure to ZIKV (B = -5.69; β = -0.26 [95% CI -11.01 to -0.36]; P = .04) and a measure of Hurricane Maria exposure (time without water, B = -0.05; β = -0.27 [95% CI, -0.10 to -0.01]; P = .03) were both independently and significantly associated with receptive language scores after adjusting for key confounders. Although infants exposed to ZIKV prenatally showed unaffected motor and visually mediated cognitive development, they did show deficits in receptive language scores. Receptive language skills were also associated with the degree of exposure to Hurricane Maria, with those who spent more time without water after the hurricane having lower receptive language scores.
Highlights
After the Zika virus (ZIKV) was first identified in 1947 in rhesus macaques in the Zika forest near Kampala, Uganda, there were a few rare and isolated cases in humans.[1]
Exposure to ZIKV (B = −5.69; β = −0.26 [95% CI −11.01 to −0.36]; P = .04) and a measure of Hurricane Maria exposure were both independently and significantly associated with receptive language scores after adjusting for key confounders
AND RELEVANCE infants exposed to ZIKV prenatally showed unaffected motor and visually mediated cognitive development, they did show deficits in receptive language scores
Summary
After the Zika virus (ZIKV) was first identified in 1947 in rhesus macaques in the Zika forest near Kampala, Uganda, there were a few rare and isolated cases in humans.[1]. The CDC4 defines ZIKV as a flavivirus that is transmitted by Aedes species mosquitoes and can cause fever, rash, and joint pain In addition to these milder symptoms, ZIKV infection early in pregnancy has been causally linked to abnormalities in brain structure, including microcephaly.[5,6,7,8] Beyond the higher incidence of microcephaly observed in newborns exposed to ZIKV during fetal development, ZIKV has been associated with ophthalmologic complications and neural abnormalities, such as thin or atrophied cerebral mantle (gray matter), absence of the cavum septum pellucidum, shortened corpus callosum, dilated ventricles, and prominent choroid plexus (which forms cerebral spinal fluid).[9,10,11,12] The latest reports[13] (from 2018) suggest that, in US territories, among 1450 children of mothers with laboratory evidence of confirmed or possible ZIKV infection, 6% of children had at least 1 identified ZIKV-associated birth defect, 9% had 1 identified ZIKV-associated neurodevelopmental abnormality, and 1% had both
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
