Pediatric Outcomes of Prenatal Zika Exposure II

产前寨卡暴露 II 的儿科结果

• 批准号: 10246565
• 负责人: LUISA I ALVARADO
• 金额: $ 18.84万
• 依托单位: PONCE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-25 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10246565
• 关键词: Address; Adherence; Aedes; Affect; Age; Attention; Awareness; Behavioral; Biological; Birth; Blood Transfusion; Brain; COVID-19; Caregivers; Caring; Centers for Disease Control and Prevention (U.S.); Child; Child Development; Childhood; Clinical; Cognitive; Cohort Studies; Communities; Congenital Abnormality; Culicidae; Data; Development; Developmental Disabilities; Disadvantaged; Disease; Early Intervention; Early identification; Emotional; Enrollment; Environmental Risk Factor; Epidemic; Epigenetic Process; Exhibits; Eye Abnormalities; Family; Family dynamics; Family health status; Fetus; First Pregnancy Trimester; Flavivirus; Goals; Health; Health Personnel; Health Policy; Health Sciences; Health Services; Healthcare; Hospitals; Immunoglobulin M; Infant; Infection; Injury; Institutes; International; Knowledge; Laboratories; Lead; Life Experience; Link; Microcephaly; Mothers; Motor; Nervous System Trauma; Neuraxis; Neurobiology; Neurologic; Newborn Infant; Outcome; Perception; Performance; Personal Satisfaction; Placenta; Play; Policies; Population; Poverty; Pregnancy; Pregnancy loss; Prevention strategy; Preventive measure; Prospective cohort; Provider; Public Health; Quality of life; Readiness; Recommendation; Research; Risk Factors; Role; School-Age Population; Schools; Sensory; Service provision; Services; Severity of illness; Source; Specialized Center; Structure; System; Time; Translating; Ultrasonography; Universities; Viral; Virus Replication; World Health Organization; ZIKA; ZIKV infection; Zika Virus; adverse outcome; behavioral outcome; clinical practice; congenital anomaly; congenital zika syndrome; critical developmental period; disease natural history; early childhood; effective intervention; experience; fetal; fetal infection; fetal loss; follow-up; health care availability; health care model; health care quality; health care service; health disparity; health equity; high risk; improved; infection risk; minority health; neonatal infection; nerve stem cell; neurobehavioral; neurovascular; pathogen; postnatal; postnatal neuronal death; postnatal period; prenatal; prevent; public health emergency; rehabilitation service; skills; social; success; tool

SUMMARY Zika virus (ZIKV) is an emerging Flavivirus transmitted by Aedes species mosquitoes, sexual contact, blood transfusions or vertically from mother to fetus. While most ZIKV infections are asymptomatic, infection during pregnancy can result in fetal loss or congenital ZIKV infection with microcephaly or other central nervous system (CNS) damage. The study team hypothesizes that neurobiological, environmental and system factors contribute to deleterious cognitive and reduced social and emotional school readiness in children born to mothers with laboratory confirmed ZIKV PCR positive and possible ZIKV IgM positive infection during pregnancy. The study team expects to improve the knowledge of the full spectrum of outcomes of congenital ZIKV infection during the critical developmental period of early childhood that should translate into better practices in the provision of services and support to families, many of which are disadvantaged. This evidence will be useful for clinicians to identify subtle neuro-developmental and behavioral abnormalities as they manifest and for families to seek early services to improve health and quality of life. The proposed research addresses the specific objective of the National Institute of Minority Health and Health Disparities to improve minority health and reduce health disparities. Aim 1 will track sensory, neurologic, developmental and behavioral outcomes and assess whether the abnormalities identified are permanent or transient or become evident over time from birth to school age. Aim 2 will expand knowledge on how environmental factors influence the outcomes of congenital ZIKV infection and which factors can be considered protective or damaging to implement preventive measures. Aim 3 will assess health equity by evaluating the access and quality of healthcare. The results obtained will help guide best practices aimed at reducing health disparities. The exploration of family dynamics that affect child development will help caregivers and providers assess and implement best practices. The identification of environmental factors will allow timely actions by agencies and the community that could protect against further damage to the developing brain. The team is confident that lessons from health equity can empower families to overcome the limitations posed by their child's congenital anomalies and developmental disabilities and increase awareness of health care providers to remove barriers to access and improve adherence. Adequate health care models will show when and how it is best to intervene while informing policy regarding system's improvements for healthier children.

摘要 寨卡病毒(Zika Virus，ZIKV)是一种通过伊蚊、性接触、血液传播的新型黄病毒 从母亲到胎儿的输血或垂直输血。虽然大多数寨卡病毒感染都是无症状的，但在 怀孕可导致胎儿丧失或先天性ZIKV感染，并伴有小头畸形或其他中枢神经系统 (CNS)损坏。研究小组假设神经生物学、环境和系统因素起作用 有害的认知和社交和情感准备降低了母亲生下的孩子的学习准备 实验室确认孕期寨卡病毒聚合酶链式反应阳性和可能的寨卡病毒IgM阳性感染。这项研究 该团队希望提高对先天性ZIKV感染结果的全谱的了解 儿童早期发展的关键时期，应转化为更好地提供 向家庭提供服务和支持，其中许多家庭处于不利地位。这一证据将有助于临床医生 发现细微的神经发育和行为异常，以便家属及早寻找 改善健康和生活质量的服务。拟议的研究针对的是 国家少数民族健康与健康差距研究所致力于改善少数民族健康和降低健康水平 差距。目标1将跟踪感觉、神经、发育和行为结果，并评估 发现的异常是永久性的或暂时性的，或随着时间的推移而变得明显，从出生到上学。 目标2将扩大关于环境因素如何影响先天性ZIKV感染结局的知识 哪些因素可以被认为是保护性的或破坏性的，以实施预防措施。目标3将 通过评估医疗保健的可获得性和质量来评估卫生公平。所获得的结果将有助于指导最佳 旨在缩小健康差距的做法。影响儿童发展的家庭动力因素探讨 将帮助护理人员和提供者评估和实施最佳做法。环境的辨认 这些因素将使机构和社区能够及时采取行动，防止 发育中的大脑。该团队相信，从健康公平中吸取的经验教训可以使家庭克服 他们的孩子先天畸形和发育障碍造成的限制，并提高认识 卫生保健服务提供者必须消除获取障碍，并提高遵从性。适当的医疗保健模式将 显示何时以及如何最好进行干预，同时告知有关系统改进以实现更健康的政策 孩子们。