School-age child neurodevelopment following antenatal Zika virus exposure
Sarah B Mulkey1,2,3, Regan Andringa-Seed4, Elizabeth Corn4
1Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA. sbmulkey@childrensnational.org.
Insights
Children with antenatal Zika virus (ZIKV) exposure showed lower IQ scores, particularly in visual reasoning, compared to unexposed peers. This highlights potential long-term neurodevelopmental impacts of ZIKV exposure in early childhood.
Area of Science:
- Pediatric Neurodevelopment
- Infectious Disease Epidemiology
- Congenital Zika Syndrome
Background:
- Limited understanding of neurodevelopmental outcomes in school-aged children with prenatal Zika virus (ZIKV) exposure.
- The 2015-2016 ZIKV epidemic impacted children now reaching school age.
Purpose of the Study:
- To evaluate and compare the neurodevelopment of ZIKV-exposed Colombian children with non-exposed controls at ages 5-6.
- To identify specific cognitive and adaptive functioning differences in ZIKV-exposed children.
Main Methods:
- Longitudinal cohort study in Atlántico, Colombia, involving 48 ZIKV-exposed children (Cases) and 118 age-matched controls.
- Assessment of multi-domain neurodevelopment using standardized measures at 5-6 years of age.
- Statistical analysis using regression models with Benjamini-Hochberg FDR correction for significance.
Main Results:
- ZIKV-exposed children (Cases) exhibited significantly lower Full-Scale IQ scores compared to both control groups (p=0.002).
- Visual reasoning deficits were a primary driver of lower IQ scores in ZIKV-exposed children (p<0.001).
- Controls experiencing COVID-19-related school delays showed more executive control and adaptive functioning issues than Cases and on-time controls.
Conclusions:
- Antenatal ZIKV exposure is associated with reduced cognitive performance, specifically lower IQ, in school-aged children.
- Neurodevelopmental differences in ZIKV-exposed children may have long-term implications.
- Continued follow-up is crucial to understand the long-term effects of prenatal ZIKV exposure on higher-order cognitive functions.
Background:
Children exposed antenatally to Zika virus (ZIKV) during the 2015-2016 epidemic are now in school; little is known about their neurodevelopment at this age. The objective was to evaluate neurodevelopment of ZIKV-exposed Colombian children compared to non-exposed controls at ages 5-6.
Methods:
In total, 48 normocephalic children with antenatal ZIKV exposure (Cases) were recruited for a longitudinal cohort study in Atlántico, Colombia. Two age-matched control groups of 118 non-ZIKV-exposed children were recruited from same communities as Cases: 63 born before ZIKV epidemic but experienced COVID-19-related school entry delays, and 55 born post-ZIKV epidemic but started school on time. Multi-domain neurodevelopment was assessed at 5-6 years using standardized measures. Standard regression and proportional odds models were used to compare outcomes. P values were adjusted using the Benjamini-Hochberg false discovery rate (FDR) (p < 0.05).
Results:
There were no differences in age at assessment between groups. Case Full-Scale IQ scores were lower than both control groups (p = 0.002), driven by visual reasoning (p < 0.001). Controls with school entry delay had more executive control problems and lower adaptive functioning skills than Cases and Controls without school entry delay.
Conclusions:
ZIKV-exposed children have lower cognitive performance compared to controls. Early childhood experiences can affect pediatric outcomes research.
Impact:
Normocephalic ZIKV-exposed children have lower full-scale IQ than their unexposed peers from the same communities. Normocephalic children with antenatal ZIKV exposure have differences in neurodevelopment that can impact them long-term. There is a need for continued follow-up of children with antenatal ZIKV exposure to determine long-term effects on higher-order areas of cognitive function.
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