Neurodevelopment of children exposed intra-uterus by Zika virus: A case series.

The main goal of this manuscript was to investigate the neurodevelopment of children exposed by Zika virus in the intrauterine period who are asymptomatic at birth. Newborns with documented Zika virus exposure during the intrauterine period who were asymptomatic at birth were followed in the first two years of life for neurodevelopment using Bayley III test. Children were classified as having normal or delayed neurodevelopment for age based on most recent Bayley III evaluation results. Eighty-four infants were included in the study. The first Bayley III evaluation was performed at a mean chronological age of 9.7±3.1 month; 13 children (15%) had a delay in one of the three domains, distributed as follow: 10 (12%) in the language domain and 3 (3.5%) in the motor domain. The most recent Bayley III evaluation was performed at a mean age 15.3±3.1 months; 42 children (50%) had a delay in one of the three domains: 4 (5%) in cognition, 31 (37%) in language, and 20 (24%) in motor performance. There were no statistical differences in Gender, Gestational Age, Birth Weight and Head Circurference at birth between children with normal and delayed neurodevelopment for age. A very high proportion of children exposed ZIKV during pregnancy who were asymptomatic at birth demonstrated a delay in neurodevelopment, mainly in the language domain, the first two years of life.

Análise da evolução do neurodesenvolvimento de crianças assintomáticas ao nascimento expostas verticalmente ao Zika Vírus / Analysis of the neurodevelopmental evolution of asymptomatic children vertically exposed to Zika Virus at birth

Introdução: A exposição vertical ao vírus Zika tem sido responsável por grandes danos neurológicos a crianças. Dentre a população com ausência de sintomas da Síndrome de Zika Congênita, ainda persistem dúvidas quanto ao potencial dano neurológico causado pela exposição, necessitando maior investigação a respeito do neurodesenvolvimento desses pacientes. Objetivo: Avaliar a evolução do neurodesenvolvimento dos recém-nascidos assintomáticos ao nascimento expostos verticalmente ao ZIKV, durante os dois primeiros anos de vida. Método: Foi realizado um estudo de série de casos de filhos de mães com infecção confirmada pelo ZIKV durante a gestação. Por meio dos prontuários e questionários, observou-se um conjunto de variáveis sociodemográficas do período pré-natal, pós-natal e do seguimento de crianças assintomáticas ao nascimento e expostas verticalmente ao ZIKV. O neurodesenvolvimento foi avaliado a partir da escala de Bayley III em duas avaliações, entre os seis meses e dois anos de vida das crianças. Diante do resultado do escore composto no Bayley III foi realizado análise estatística das variáveis selecionadas correlacionando as crianças com ou sem alteração na última avaliação do Bayley III. Resultados: Foi possível verificar uma piora do neurodesenvolvimento dessa população, principalmente na área da linguagem, durante os dois primeiros anos de vida. Houve uma relação estatisticamente significativa da alteração do neurodesenvolvimento com a variação do perímetro cefálico. Não foi possível identificar correlação entre outras variáveis analisadas com o atraso no neurodesenvolvimento. Discussão/Conclusão: O ZIKV afeta as células progenitoras neurais e pode causar comprometimento cerebral em diversas fases do neurodesenvolvimento. Este trabalho evidenciou uma piora do neurodesenvolvimento nos primeiros dois anos de vida e também uma relação entre a variação do perímetro cefálico com essas alterações. Portanto, faz-se necessária a continuidade da investigação nessas crianças, com o intuito de definir melhor a fisiopatologia da doença e traçar novas estratégias e terapias para reabilitação desses pacientes.

Introduction: Vertical exposure to Zika virus has been responsible for major neurological damage to children. Among the population with no symptoms of Congenital Zika Syndrome, there are still doubts about the potential neurological damage caused by Zika virus exposure during pregnancy, requiring further investigation regarding the neurodevelopment of these patients. Objective: To evaluate the neurodevelopmental evolution of the asymptomatic newborns exposed vertically to ZIKV during the first 2 years of life. Method: A case series study was carried out of children of mothers with ZIKV-confirmed infection during pregnancy. A set of sociodemographic variables of the pre and postnatal period and the follow up of children exposed vertically to the ZIKV who were asymptomatic at birth were observed in the patients' and questionnaires. Neurodevelopment was evaluated using Bayley III in two different occasions in children between the ages of 6 months and 2 years. was used to evaluate the factors related to the difference in Bayley's results. A statistical analysis of the selected variables was performed correlating the children with or without alteration in the last evaluation of Bayley III. Results: It was possible to verify a neurodevelopmental decay in this population, especially in the area of language, during the first 2 years of life. There was a statistically significant relationship between head circumference variation with neurodevelopmental worsening. It was not possible to identify a correlation between other variables analyzed with the delay in neurodevelopment. Discussion / Conclusion: ZIKV affects neural progenitor cells and can cause brain damage in various stages of neurodevelopment. Discussion / Conclusion: ZIKV affects neural progenitor cells and can cause brain damage in various stages of neurodevelopment. This work evidences a worsening of neurodevelopment in the first 2 years of life, as well as a relationship between the variation of head circumference and these alterations. Therefore, it is necessary to continue the investigation in these children, in order to better define the pathophysiology of the disease and to outline new strategies and effective therapies for these patients.