Zika Virus Infection during Pregnancy and Effects on Early Childhood Development, French Polynesia, 2013–2016

Abstract

Congenital Zika virus syndrome consists of a large spectrum of neurologic abnormalities seen in infants infected with Zika virus in utero. However, little is known about the effects of Zika virus intrauterine infection on the neurocognitive development of children born without birth defects. Using a case-control study design, we investigated the temporal association of a cluster of congenital defects with Zika virus infection. In a nested study, we also assessed the early childhood development of children recruited in the initial study as controls who were born without known birth defects,. We found evidence for an association of congenital defects with both maternal Zika virus seropositivity (time of infection unknown) and symptomatic Zika virus infection during pregnancy. Although the early childhood development assessment found no excess burden of developmental delay associated with maternal Zika virus infection, larger, longer-term studies are needed.

The role of pregnant women with rash in the Zika virus sentinel surveillance

“…The majority of confirmed cases of ZIKV occurred in the second and third trimesters of gestation. However, when analyzing the trimester of ZIKV infection in children born with microcephaly, we noticed that most of them became infected in the first trimester of pregnancy, which is compatible with the literature, since pregnant women with infection in the first trimester have the most severe cases, as well as an increased risk of microcephaly in their conceptuses 11,12,13 .…”

Zika virus during pregnancy: From maternal exposure to congenital Zika virus syndrome

“…Vermian hypoplasia and global cerebellar hypoplasia were reported in 42% and 21% to 82% of CZS cases, respectively . The brainstem can also be hypoplastic or dysplastic and is associated with extra‐cerebral abnormalities such as swallowing disorders and hydramnios (25%) as well as partial immobilization or arthrogryposes (10%‐25%) …”

“…Another study reported feeding challenges, sleeping difficulties, severe motor impairment, vision and hearing abnormalities, and/or seizures disorders in all 18‐ to 24‐month old infants born with CZS . Long‐term sequelae, particularly regarding neuro‐development and cognitive function of these infants, however, remain insufficiently investigated …”

“…57,73 The brainstem can also be hypoplastic or dysplastic and is associated with extracerebral abnormalities such as swallowing disorders and hydramnios (25%) as well as partial immobilization or arthrogryposes (10%-25%). 57,60,64,74,75…”

“…88 Long-term sequelae, particularly regarding neuro-development and cognitive function of these infants, however, remain insufficiently investigated. 75 5 | MANAGEMENT OF EXPOSED PREGNANCIES AND RECOMMANDATIONS…”