Neurodevelopment outcomes in infants born to women with Zika virus infection during pregnancy in Mexico
Neurodevelopment outcomes in infants born to women with Zika virus infection during pregnancy in Mexico
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DOI：
10.1111/cch.12842
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发表时间：
2020-12-28
影响因子：
1.9
通讯作者：
Ruisenor-Escudero, Horacio
中科院分区：
文献类型：
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作者：
Familiar, Itziar;Boivin, Michael;Ruisenor-Escudero, Horacio
背景在墨西哥，很少有研究评估感染寨卡病毒(ZIKV)的妇女在怀孕期间所生的正常头位婴儿的神经发育结果。我们试图用基于表现和眼睛凝视的神经发育测量来评估墨西哥尤卡坦地区暴露于ZIKV的婴儿，消除了观察者的偏见。方法我们招募了60名孕妇在6个月大时出生的婴儿进行ZIKV的PCR+检测。婴儿头位正常，无症状。没有ZIKV感染史的妇女所生的60名婴儿作为对照。使用马伦早期学习量表(运动、语言和整体认知技能发展量表)和费根婴儿智力测验(Fagan测验)来评估婴儿对人脸的视觉偏好，其中预期对陌生(即新)面孔的凝视时间更长。结果ZIKV接触组儿童除表达语言外，所有MSEL分量表的得分均显著低于对照组，包括总体标准复合体(分别为80+/-10vs.87+/-7.4p<；0.001)。FTII的注视和凝视长度的眼球跟踪测量在预期的方向上，控制组的婴儿记录的时间更长(即更高的注意力)，但没有达到统计学意义。在调整的线性回归中，FTII高新颖性分数(期望新面孔的偏好)预测精细运动(Beta=3.61，p=0.04)和接受性语言(Beta=2.55，p=0.03)得分。结论墨西哥ZIKV患者孕期所生的非小头畸形儿童应进行早期神经发育评估，以便进行适当的干预和临床随访。可能需要为一部分受影响的病例建立对认知缺陷的长期监测。
Background Few studies have assessed neurodevelopmental outcomes in normocephalic infants born to women with Zika virus (ZIKV) infection during pregnancy in Mexico. We sought to evaluate ZIKV exposed infants in Yucatan, Mexico, with performance-based and eye-gaze measures of neurodevelopment, removing observer bias.Methods We enrolled 60 infants about 6-month old born to women with PCR + test for ZIKV during pregnancy. Infants were normocephalic and asymptomatic. Sixty infants born to women without a history of ZIKV infection were included as comparison. Children were assessed with the Mullen scales of early learning (MSEL), a test with scales in motor, language, and overall cognitive skills development, and the Fagan test of infant intelligence (FTII) using automated eye-tracking instrumentation to evaluate infant visual preference of human faces, where longer gaze lengths to unfamiliar (i.e., new) faces are expected.Results All MSEL subscale scores, except expressive language, were significantly lower among ZIKV exposed children compared to controls, including the overall standard composite (80 +/- 10 vs. 87 +/- 7.4, respectively; p < 0.001). FTII eye-tracking measures of fixation and gaze length were in the expected direction, with longer times recorded among infants in the control group (i.e., higher attention), but none reached statistical significance. In adjusted linear regressions, the FTII high novelty score (expected preference for a novel face) predicted fine motor (beta = 3.61, p = 0.04) and receptive language (beta = 2.55, p = 0.03) scores.Conclusions Nonmicrocephalic children born to women with ZIKV during pregnancy in Mexico merit early neurodevelopmental evaluation to allow for appropriate interventions and clinical follow-up. It is possible that long-term monitoring of cognitive deficits may need to be established for a proportion of affected cases.