Pediatric Outcomes of Prenatal Zika Exposure II

产前寨卡暴露 II 的儿科结果

• 批准号: 10569010
• 负责人: LUISA I ALVARADO
• 金额: $ 45.39万
• 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 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569010
• 关键词: Address; Adherence; Aedes; Affect; Age; Attention; Awareness; Behavioral; Biological; Birth; Blood Transfusion; Brain; Caregivers; Caring; Centers for Disease Control and Prevention (U.S.); Central Nervous System; Child; Child Development; Childhood; Clinical; Cognitive; Cohort Studies; Communities; Congenital Abnormality; Culicidae; Data; Development; Developmental Disabilities; Disadvantaged; Disease; Disparity; Early Intervention; Early identification; Emotional; Enrollment; Environmental Health; 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; International; Knowledge; Laboratories; Lead; Link; Microcephaly; Mothers; Motor; National Institute on Minority Health and Health Disparities; Nervous System Trauma; Neurobiology; Neurologic; Newborn Infant; Outcome; Perception; Performance; Personal Satisfaction; Placenta; Policies; Population; Poverty; Pregnancy; Pregnancy loss; Prevention strategy; Preventive measure; Prospective cohort; Provider; Public Health; Quality of life; Readiness; Recommendation; Reduce health disparities; Rehabilitation therapy; Research; Risk; Risk Factors; School-Age Population; Schools; Sensory; Service provision; Services; Severity of illness; Source; Specialized Center; System; Time; Translating; Ultrasonography; Universities; Viral; Virus Replication; World Health Organization; ZIKA; ZIKV infection; Zika Virus; access disparities; adverse outcome; behavior prediction; behavioral outcome; care providers; clinical practice; congenital anomaly; congenital zika syndrome; critical developmental period; disease natural history; early childhood; effective intervention; empowerment; experience; fetal; fetal infection; fetal loss; follow-up; health assessment; health care availability; health care model; health care quality; health care service; health disparity; health equity; high risk; improve minority health; improved; infant infection; nerve stem cell; neurobehavioral; neurovascular; pathogen; postnatal; postnatal neuronal death; postnatal period; prenatal; prevent; public health emergency; skills; social; success; tool; transmission process

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.

总结 寨卡病毒（ZIKV）是一种新出现的黄病毒，通过伊蚊属蚊子、性接触、血液传播。 输血或垂直从母亲到胎儿。虽然大多数ZIKV感染是无症状的，但感染期间 妊娠可导致胎儿丢失或先天性ZIKV感染伴小头畸形或其他中枢神经系统 (CNS)损害研究小组假设，神经生物学，环境和系统因素有助于 有害的认知和降低社会和情感的学校准备的母亲， 实验室证实在怀孕期间ZIKV PCR阳性和可能的ZIKV IgM阳性感染。研究 研究小组希望在研究期间提高对先天性ZIKV感染的全方位结果的认识。 儿童早期发展的关键时期，应转化为提供 向家庭提供服务和支助，其中许多家庭处于不利地位。这一证据将有助于临床医生 发现微妙的神经发育和行为异常，因为他们表现出来，并为家庭寻求早期 服务，以改善健康和生活质量。拟议的研究涉及的具体目标 国家少数民族健康和健康差异研究所，以改善少数民族健康和减少健康 差距。目标1将跟踪感觉，神经，发育和行为结果，并评估是否 所发现的异常是永久性的或暂时性的，或随着从出生到学龄的时间而变得明显。 目标2将扩大有关环境因素如何影响先天性ZIKV感染结果的知识 以及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及性和质量来评估卫生公平性。获得的结果将有助于指导最好的 旨在减少健康差距的做法。探索影响儿童发展的家庭动态 将帮助护理人员和提供者评估和实施最佳做法。环境识别 这些因素将使各机构和社区能够及时采取行动，防止进一步损害 大脑发育该团队相信，健康公平的经验教训可以帮助家庭克服困难 儿童先天性异常和发育障碍造成的限制，并提高认识 卫生保健提供者消除障碍，提高依从性。适当的保健模式将 显示何时以及如何最好地进行干预，同时告知有关系统改进的政策， 孩子