Neurodevelopmental Follow-Up in Children with Intrauterine and Perinatal Exposure to Chikungunya Virus

IF 3.9 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2025-01-27 DOI:10.1016/j.jpeds.2025.114477

Fátima Cristiane Pinho de Almeida Di Maio Ferreira MD, PhD , Karin Nielsen-Saines MD, MPH , Maria Elisabeth Lopes Moreira MD, PhD , Aline Dessimoni Salgado MD , Roozemeria Pereira Costa MS , Simone B. de Campos PhD , Dajie Zhang PhD , Britta Hüning MD , Christa Einspieler PhD , Peter B. Marschik Dphil, DMsc, PhD , Trevon Fuller PhD , Patricia Brasil MD, PhD

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引用次数: 0

Abstract

Objective

To investigate the effects of intrauterine and perinatal exposure to chikungunya virus (CHIKV) on neurodevelopment in infants and toddlers.

Study design

We conducted a cohort study comparing children with intrauterine or perinatal exposure to maternal CHIKV infection with unexposed controls in Rio de Janeiro, Brazil. Neurodevelopment was assessed with General Movement Assessments in the first 6 months of life, and the Bayley-III Scales of Infant and Toddler Development and Modified Checklist for Autism in Toddlers for older children. Developmental delay (DD) was defined as a Bayley score less than 70 and risk of DD as a score less than 85.

Results

Among 60 children exposed to intrauterine or perinatal CHIKV, 20 (33%) had laboratory confirmation of CHIKV infection by reverse transcription polymerase chain reaction or immunoglobulin M serology and 40 did not; 44 exposed children (15 infected and 29 uninfected) had General Movement Assessment performed, with 19% having suboptimal or abnormal results. At 11-42 months of age, 35 exposed children and 78 unexposed controls had Bayley-III assessments. Compared with controls, exposed children had higher rates of DD (7 [20%] vs 2 [3%], P = .004) driven by the language domain, and greater risk of DD driven by motor and cognitive domains scores (10 [29%] vs 10 [13%], P = .03 and 8 [23%] vs 5 [6%], P = .02, respectively). Eight of 35 (23%), CHIKV exposed children screened positive for autism spectrum disorder. CHIKV-exposed uninfected children had 2 (9.5%) cases of DD and 5 (23.8%) cases of autism spectrum disorder.

Conclusions

Abnormal neurodevelopmental results were seen in both infected and uninfected children with intrauterine or perinatal CHIKV exposure. Infant neurodevelopment monitoring should be considered following exposure to maternal CHIKV infection in pregnancy to facilitate early interventions and to mitigate neurodevelopmental sequelae.

查看原文本刊更多论文

基孔肯雅病毒宫内和围产期暴露儿童的神经发育随访。

目的：探讨基孔肯雅病毒（CHIKV）宫内及围生期暴露对婴幼儿神经发育的影响。研究设计：我们在巴西里约热内卢进行了一项队列研究，比较了宫内或围产期暴露于母体CHIKV感染的儿童与未暴露的对照组。前6个月采用一般运动评估（GMA）评估神经发育，大一点的儿童采用Bayley-III婴幼儿发育量表和修改的幼儿自闭症检查表（M-CHAT）评估神经发育。发育迟缓（DD）被定义为Bayley评分小于70分，DD风险被定义为小于85分。结果：在60名宫内或围产期暴露于CHIKV的儿童中，20名（33%）通过RT-PCR或IgM血清学检测证实了CHIKV感染，40名没有；44名暴露儿童（15名感染和29名未感染）进行了GMA，其中19%的结果不理想或异常。在11至42个月大时，35名暴露儿童和78名未暴露对照进行了贝利- iii评估。与对照组相比，暴露儿童由语言领域驱动的DD发生率更高（7[20%]比2 [3%]，p=0.004），由运动和认知领域评分驱动的DD风险更高（10[29%]比10 [13%]，p=0.03和8[23%]比5 [6%]，p=0.02）。35名暴露于CHIKV的儿童中有8名（23%）筛查出自闭症谱系障碍阳性。暴露于chikv的未感染儿童有2例DD（9.5%）和5例ASD（23.8%）。结论：宫内或围产期暴露于CHIKV感染和未感染儿童均可出现神经发育异常。妊娠期暴露于母体感染CHIKV病毒后，应考虑对婴儿进行神经发育监测，以促进早期干预和减轻神经发育后遗症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.