Dataset Information

Sequential Neuroimaging of the Fetus and Newborn With In Utero Zika Virus Exposure.

ABSTRACT:

Importance

The evolution of fetal brain injury by Zika virus (ZIKV) infection is not well described.

Objectives

To perform longitudinal neuroimaging of fetuses and infants exposed to in utero maternal ZIKV infection using concomitant magnetic resonance imaging (MRI) and ultrasonography (US), as well as to determine the duration of viremia in pregnant women with ZIKV infection and whether the duration of viremia correlated with fetal and/or infant brain abnormalities.

Design, setting, and participants

A cohort of 82 pregnant women with clinical criteria for probable ZIKV infection in Barranquilla, Colombia, and Washington, DC, were enrolled from June 15, 2016, through June 27, 2017, with Colombian women identified by community recruitment and physician referral and travel-related cases of American women recruited from a Congenital Zika Program.

Interventions and exposures

Women received 1 or more MRI and US examinations during the second and/or third trimesters. Postnatally, infants underwent brain MRI and cranial US. Blood samples were tested for ZIKV.

Main outcomes and measures

The neuroimaging studies were evaluated for brain injury and cerebral biometry.

Results

Of the 82 women, 80 were from Colombia and 2 were from the United States. In 3 of 82 cases (4%), fetal MRI demonstrated abnormalities consistent with congenital ZIKV infection. Two cases had heterotopias and malformations in cortical development and 1 case had a parietal encephalocele, Chiari II malformation, and microcephaly. In 1 case, US results remained normal despite fetal abnormalities detected on MRI. Prolonged maternal polymerase chain reaction positivity was present in 1 case. Of the remaining 79 cases with normal results of prenatal imaging, postnatal brain MRI was acquired in 53 infants and demonstrated mild abnormalities in 7 (13%). Fifty-seven infants underwent postnatal cranial US, which detected changes of lenticulostriate vasculopathy, choroid plexus cysts, germinolytic/subependymal cysts, and/or calcification in 21 infants (37%).

Conclusions and relevance

In a cohort of pregnant women with ZIKV infection, prenatal US examination appeared to detect all but 1 abnormal fetal case. Postnatal neuroimaging in infants who had normal prenatal imaging revealed new mild abnormalities. For most patients, prenatal and postnatal US may identify ZIKV-related brain injury.

SUBMITTER: Mulkey SB

PROVIDER: S-EPMC6583436 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Sequential Neuroimaging of the Fetus and Newborn With In Utero Zika Virus Exposure.

Mulkey Sarah B SB Bulas Dorothy I DI Vezina Gilbert G Fourzali Yamil Y Morales Armando A Arroyave-Wessel Margarita M Swisher Christopher B CB Cristante Caitlin C Russo Stephanie M SM Encinales Liliana L Pacheco Nelly N Kousa Youssef A YA Lanciotti Robert S RS Cure Carlos C DeBiasi Roberta L RL du Plessis Adre J AJ

JAMA pediatrics 20190101 1

<h4>Importance</h4>The evolution of fetal brain injury by Zika virus (ZIKV) infection is not well described.<h4>Objectives</h4>To perform longitudinal neuroimaging of fetuses and infants exposed to in utero maternal ZIKV infection using concomitant magnetic resonance imaging (MRI) and ultrasonography (US), as well as to determine the duration of viremia in pregnant women with ZIKV infection and whether the duration of viremia correlated with fetal and/or infant brain abnormalities.<h4>Design, se ...[more]

PMID: 30476967

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Project description:BackgroundIn utero exposure to Zika virus (ZIKV) is known to be associated with birth defects. The impact of in utero ZIKV exposure on neurodevelopmental outcomes in early childhood remains unclear. The objective of this study was to determine the impact of in utero ZIKV exposure on neurodevelopment at 24?months of age among toddlers who were born normocephalic to women who were pregnant during the 2016 ZIKV outbreak in French territories in the Americas.MethodsWe conducted a population-based mother-child cohort study of women whose pregnancies overlapped with the 2016 ZIKV epidemic in Guadeloupe, Martinique, and French Guiana. Infants were included in this analysis if maternal ZIKV infection during pregnancy could be determined, the newborn had a gestational age ? 35?weeks, there were no abnormal transfontanelle cerebral ultrasound findings after delivery or no abnormal ultrasound findings on the last ultrasound performed during the third trimester of the mother's pregnancy, there was an absence of microcephaly at birth, and the parent completed the 24-month neurodevelopment assessment of the infant at 24?months (±?1?month) of age. ZIKV exposure of the toddler was determined by evidence of maternal ZIKV infection during pregnancy. Neurodevelopment assessments included the Ages and Stages Questionnaire (ASQ) for five dimensions of general development-communication, gross motor, fine motor, problem solving, and personal-social skills; the Modified Checklist for Autism on Toddlers (M-CHAT) for behavior; and the French MacArthur Inventory Scales (IFDC) for French language acquisition.ResultsBetween June 2018 and August 2019, 156 toddlers with and 79 toddlers without in utero ZIKV exposure completed neurodevelopment assessments. Twenty-four (15.4%) ZIKV-exposed toddlers and 20 (25.3%) ZIKV-unexposed toddlers had an ASQ result below the reference -?2SD cut-off (P?=?0.10) for at least one of the five ASQ dimensions.ConclusionIn one of the largest population-based cohorts of in utero ZIKV-exposed, normocephalic newborns to date, there were minimal differences apparent in neurodevelopment outcomes at 24?months of age compared to ZIKV-unexposed toddlers at 24?months of age.Trial registrationClinicalTrials.gov, NCT02810210 . Registered 20 June 2016.

Dataset Information

Sequential Neuroimaging of the Fetus and Newborn With In Utero Zika Virus Exposure.

Importance

Objectives

Design, setting, and participants

Interventions and exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Sequential Neuroimaging of the Fetus and Newborn With In Utero Zika Virus Exposure.

Similar Datasets

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