Prenatal cytomegalovirus, rubella, and Zika virus infections associated with developmental disabilities: past,
Eliza Gordon-Lipkin1,2,3, Alexander Hoon1, Carlos A Pardo2,4
1Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, Maryland, USA.
Insights
Prenatal infections like Zika virus can cause developmental disabilities. Historical data from rubella and cytomegalovirus inform approaches to new congenital infections, showing maternal illness severity doesn't predict infant outcomes.
Area of Science:
- Neuroscience
- Infectious Diseases
- Developmental Biology
Background:
- Prenatal infections are significant, preventable causes of developmental disabilities.
- The spectrum of pathogens impacting fetal brain development is expanding, notably with Zika virus (ZIKV) and microcephaly.
- Understanding historical pathogen impacts is crucial for addressing novel congenital infections.
Observation:
- Rubella, cytomegalovirus, and ZIKV serve as key historical examples of prenatal infections affecting fetal development.
- These historical cases provide a framework for understanding and managing emerging congenital infections.
- Maternal illness severity does not correlate with the severity of infant sequelae.
Findings:
- The list of prenatal infections linked to developmental disabilities is growing.
- Lessons from rubella, cytomegalovirus, and ZIKV are applicable to emerging pathogens.
- Congenital infections are preventable, and public health strategies can mitigate risks.
Implications:
- Established knowledge from past epidemics can guide responses to new infectious threats.
- Early identification and intervention strategies are vital for managing congenital infections.
- Public health initiatives are essential for preventing prenatal infections and treating their consequences.
Abstract:
Prenatal infections have long been recognized as important, preventable causes of developmental disabilities. The list of pathogens that are recognized to have deleterious effects on fetal brain development continues to grow, most recently with the association between Zika virus (ZIKV) and microcephaly. To answer clinical questions in real time about the impact of a novel infection on developmental disabilities, an historical framework is key. The lessons learned from three historically important pathogens: rubella, cytomegalovirus, and ZIKV, and how these lessons are useful to approach emerging congenital infections are discussed in this review. Congenital infections are preventable causes of developmental disabilities and several public health approaches may be used to prevent prenatal infection. When they cannot be prevented, the sequelae of prenatal infection may be treatable. WHAT THIS PAPER ADDS: The list of prenatal infections associated with developmental disabilities continues to increase. Lessons learned from rubella, cytomegalovirus, and Zika virus have implications for new pathogens. Severity of illness in the mother does not correlate with severity of sequelae in the infant.
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