Neurodevelopmental assessment of normocephalic children born to Zika virus exposed and unexposed pregnant people.

BACKGROUND: Studies examining the association between in utero Zika virus (ZIKV) exposure and child neurodevelopmental outcomes have produced varied results. METHODS: We aimed to assess neurodevelopmental outcomes among normocephalic children born from pregnant people enrolled in the Zika in Pregnancy in Honduras (ZIPH) cohort study, July-December 2016. Enrollment occurred during the first prenatal visit. Exposure was defined as prenatal ZIKV IgM and/or ZIKV RNA result at enrollment. Normocephalic children, >6 months old, were selected for longitudinal follow-up using the Bayley Scales of Infant and Toddler Development (BSID-III) and the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE-2). RESULTS: One hundred fifty-two children were assessed; after exclusion, 60 were exposed and 72 were unexposed to ZIKV during pregnancy. Twenty children in the exposed group and 21 children in the unexposed group had a composite score <85 in any of the BSID-III domains. Although exposed children had lower cognitive and language scores, differences were not statistically significant. For ASQ:SE-2 assessment, there were not statistically significant differences between groups. CONCLUSIONS: This study found no statistically significant differences in the neurodevelopment of normocephalic children between in utero ZIKV exposed and unexposed. Nevertheless, long-term monitoring of children with in utero ZIKV exposure is warranted. IMPACT: This study found no statistically significant differences in the neurodevelopment in normocephalic children with in utero Zika virus exposure compared to unexposed children, although the exposed group showed lower cognitive and language scores that persisted after adjustment by maternal age and education and after excluding children born preterm and low birth weight from the analysis. Children with prenatal Zika virus exposure, including those normocephalic and have no evidence of abnormalities at birth, should be monitored for neurodevelopmental delays. Follow-up is important to be able to detect developmental abnormalities that might not be detected earlier in life.

Microcephaly Outcomes among Zika Virus-Infected Pregnant Women in Honduras.

The impact of Zika virus (ZIKV) infection on pregnancies shows regional variation emphasizing the importance of studies in different geographical areas. We conducted a prospective study in Tegucigalpa, Honduras, recruiting 668 pregnant women between July 20, 2016, and December 31, 2016. We performed Trioplex real-time reverse transcriptase-PCR (rRT-PCR) in 357 serum samples taken at the first prenatal visit. The presence of ZIKV was confirmed in seven pregnancies (7/357, 2.0%). Nine babies (1.6%) had microcephaly (head circumference more than two SDs below the mean), including two (0.3%) with severe microcephaly (head circumference [HC] more than three SDs below the mean). The mothers of both babies with severe microcephaly had evidence of ZIKV infection. A positive ZIKV Trioplex rRT-PCR was associated with a 33.3% (95% CI: 4.3-77.7%) risk of HC more than three SDs below the mean.

Caracterización de la Investigación realizada en el postgrado de ginecología y Obstetricia, Facultad de Ciencias Medicas UNAH, 2012-2015 / Characterization of the research performed at the Gynecology and Obstetrics Postgraduate Program, Facultad de Ciencias Médicas, UNAH, 2012-2015

Antecedentes: La investigación es un componente esencial de un programa de posgrado y debe responder a problemas prioritarios institucionales, académicos y asistenciales. Objetivo: Caracterizar la investigación realizada en el Posgrado de Ginecología y Obstetricia, Facultad de Ciencias Médicas (FCM) UNAH, 2012-2015. Metodología: Estudio descriptivo transversal. Unidad de análisis: 1) Suplemento Congreso, Revista Médica Posgrados de Medicina UNAH, 2012-2014; 2) Médicos Residentes Tercer Año cohorte 2013-2015, previo consentimiento informado verbal. Se registró tema, lugar, diseño, unidad de análisis, equipo investigador, aspectos éticos, financiamiento y relación con líneas prioritarias de investigación FCM UNAH 2012-2017. Resultados: Se identificaron 58 estudios, 44 (75.9%) periodo 2012-2014. Los temas más frecuentes de 39 (67.2%) en área obstétrica: Trastornos hipertensivos y Hemorragia posparto, 4 (10.2%) cada uno; de 18 (31.0%) área ginecológica: Cuidados pos-anestésico/pos-operatorio y Sangrado uterino anormal, 4 (22.2%) cada uno. Del total, 33 (56.9%) correspondieron a Línea Morbimortalidad materno-infantil, 18 (31.0%) a Línea Enfermedades crónicas no transmisibles; 70.7% (41) correspondió a estudios descriptivos, 8.6% (5) contó con dictamen ético, 20.7% (12) obtuvo consentimiento informado; 14 (24.1%) se financiaron con fondos personales (2015). Discusión: La investigación realizada en el Posgrado de Ginecología y Obstetricia FCM UNAH en el periodo 2012-2015 provee resultados con un nivel muy bajo de evidencia científica. Es necesario iniciar acciones para fortalecer la capacidad institucional de realizar y utilizar los resultados de la investigación. La investigación será relevante en la medida en que esté vinculada, a través de la priorización, con el desarrollo institucional y el desarrollo económico y social del país...(AU)