Children Born With Congenital Zika Syndrome Display Atypical Gross Motor Development and a Higher Risk for Cerebral Palsy

Abstract

Importance:

Congenital Zika syndrome virus infection is said to interfere in children’s development.

Objective:

evaluate gross motor trajectories and the frequency of cerebral palsy in children with congenital Zika syndrome.

Design:

Cohort study applying the Alberta Infant Motor Scale (AIMS) and the Bayley III Scales in infants from 6 to 18 months of age.

Setting:

The SARAH network, Rio de Janeiro.

Participants:

Thirty-nine infants whose diagnoses were established through clinical history, serology tests, and neuroimaging findings. Main outcomes and measures: Congenital Zika syndrome is associated with severe motor delays and is a risk factor to the diagnosis of cerebral palsy.

Results:

The Alberta Infant Motor Scale mean raw score at 6 months was 9.74 (SD 4.80) or equivalent to 2 to 3 months of motor developmental age. At the age of 12 months, 14.13 (SD 11.90), corresponding to 3 to 4 months of motor development age; the Bayley III Scales results correlated to the Alberta Infant Motor Scale (P < .001) at this age. At 18 months, 15.77 (SD 13.80) or a motor development equivalent to 4 to 5 months of age. Thirty-five of 39 children (89.7%) met criteria for the diagnosis of cerebral palsy. Conclusions and relevance: Gross motor development marginally progresses from 6 to 18 months of age. These individuals also displayed a high frequency of cerebral palsy.

Keywords

congenital Zika syndrome cerebral palsy gross motor development

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References

Early Childhood Development: The key to a full and productive life. UNICEF. https://www.unicef.org/dprk/ecd.pdf.

Melo

Aguiar

Amorim

. Congenital Zika virus infection: beyond neonatal microcephaly. JAMA Neurol. 2016;73(12):1407–1416.

Jacobsson

Hagberg

. Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol. 2004;18(3):425–436.

Mlakar

Korva

Tul

. Zika virus associated with microcephaly. N Engl J Med. 2016;374(10):951–958.

Moore

Staples

Dobyns

. Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians. JAMA Pediatr. 2017;171(3):288–295.

Braga

Campos da Paz

, eds. The Child With Traumatic Brain Injury or Cerebral Palsy: A Context-Sensitive, Family-Based Approach to Development. Oxford, UK: Taylor & Francis 2005.

de Fatima Vasco Aragao

van der Linden

Brainer-Lima

. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study. BMJ. 2016;353:i1901.

Valentini

Saccani

. Escala Motora Infantil de Alberta: validação para uma população gamaging. Revista Paulista de Pediatria 2011;29(2):231–238.

Piper

Pinnell

Darrah

Maguire

Byrne

. Construction and validation of the Alberta Infant Motor Scale (AIMS). Can J Public Health. 1992;2:S46–S50.

10.

Holanda Silva

NDS

Lamy Filho

Alves Gama

de Carvalho Lamy

do Lago Pinhiero

do Nascimento Silva

. Instrumentos de avaliação do desenvolvimento infantil de recém-nascidos prematuros. Revista Brasileira de Crescimento e Desenvolvimento Humano, São Paulo 2011;21(1):85–98.

11.

Novak

Morgan

Adde

. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171(9):897–907.

12.

Ioos

Mallet

Leparc Goffart

Gauthier

Cardoso

Herida

. Current Zika virus epidemiology and recent epidemics. Med Mal Infect. 2014;44(7):302–307.

13.

Ribeiro

Werner

Lopes

FPPL

. Central nervous system effects of intrauterine Zika virus infection: a pictorial review. Radiographics. 2017;37(6):1840–1850.

14.

Hagen

Pivarcsi

Liebe

. Diagnostic approach to microcephaly in childhood: a two-center study and review of the literature. Dev Med Child Neurol. 2014;56(8):732–741.

15.

Dolk

. The predictive value of microcephaly during the first year of life for mental retardation at seven years. Dev Med Child Neurol. 2001;33(11):974–983.

16.

Gale

O’Callaghan

Bredow

Martyn

; Avon Longitudinal Study of Parents and Children Study Team. The influence of head growth in fetal life, infancy, and childhood on intelligence at the ages of 4 and 8 years. Pediatrics. 2006;118(4):1486–1492.

17.

Rintala

Loovis

. Measuring motor skills in Finnish children with intellectual disabilities. Percept Mot Skills. 2013;116(1):294–303.

18.

Martinot

Abbink

Afacan

. Fetal neuropathology in Zika virus-infected pregnant female rhesus monkeys. Cell. 2018;173(5):1111–1122.

19.

da Silva Pone

Moura Pone

Araujo Zin

. Zika virus infection in children: epidemiology and clinical manifestations. Childs Nerv Syst. 2018;34(1):63–71.

20.

Leyser

Nascimento

OJM

. Congenital Zika virus infection beyond neonatal microcephaly. JAMA Neurol. 2017;74(5):610.

21.

Leyser

Fernandes

Passos

. Microcephaly and arthrogryposis multiplex congenita: the full-blown CNS spectrum in newborns with ZIKV infection. J Neurol Sci. 2017;372:73–74.

22.

Chimelli

Melo

ASO

Avvad-Portari

. The spectrum of neuropathological changes associated with congenital Zika virus infection. Acta Neuropathol. 2017;133(6):983–999.

23.

Satterfield-Nash

Kotzky

Allen

. Health and development at age 19-24 months of 19 children who were born with microcephaly and laboratory evidence of congenital Zika virus infection during the 2015 Zika Virus Outbreak - Brazil, 2017. MMWR Morb Mortal Wkly Rep. 2017;66(49):1347–1351.

24.

Calvet

Aguiar

Melo

ASO

. Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study. Lancet Infect Dis. 2016;16(6):653–660.