Abstract
ABSTRACTWe report cognitive, language and motor neurodevelopment, assessed by the Bayley-III test, in 31 non-microcephalic children at age 3 with PCR-confirmed maternal Zika virus exposure (Rio de Janeiro, 2015–2016). Most children had average neurodevelopmental scores, however, 8 children (26%) presented delay in some domain. Language was the most affected: 7 children (22.6%) had a delay in this domain (2 presenting severe delay). Moderate delay was detected in the cognitive (3.2%) and motor (10%) domains. Maternal illness in the third trimester of pregnancy and later gestational age at birth were associated with higher Bayley-III scores. Zika-exposed children require long-term follow-up until school age.
Highlights
Zika virus (ZIKV) can damage the developing brain of infants with antenatal exposure to acute maternal illness with complications leading to fetal or infant death
The majority of our non-microcephalic children exposed to antenatal ZIKV infection had composite scores above 85 on Bayley-III cognitive and motor domains (96.8% and 90%, respectively), suggesting a predominantly normal neurodevelopmental outcome in the third year of life
The main concern following antenatal ZIKV exposure is whether clinical manifestations appear later in life in non-microcephalic infants
Summary
Zika virus (ZIKV) can damage the developing brain of infants with antenatal exposure to acute maternal illness with complications leading to fetal or infant death. Congenital microcephaly is the most dramatic sequela, Congenital Zika Syndrome (CZS) includes a wide range of neurological abnormalities even in non-microcephalic infants, such as seizures, hypertonia/hypotonia, ataxia, dyskinesia, irritability, abnormal posturing and movements, as well as auditory and visual deficits. Many of these findings are associated with delayed neurodevelopment[1]. Microcephalic infants with CZS show severe delay and atypical neurodevelopment during their first years of life[1], while little is known regarding asymptomatic non-microcephalic children with antenatal ZIKV exposure. The most recent analysis of 216 ZIKV-exposed children from the Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil, revealed below-average neurodevelopment and/or abnormal eye or hearing assessments in 31.5% of children between 7 to 32 months of age[2]
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