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. 2021 Jan 5;87(1):4.
doi: 10.5334/aogh.3095.

Birth Defects and Long-Term Neurodevelopmental Abnormalities in Infants Born During the Zika Virus Epidemic in the Dominican Republic

Raquel Pimentel  1 , Shaveta Khosla  2 , Josefina Rondon  3 , Farah Peña  1 , Gwyneth Sullivan  4 , Martha Perez  1 , Supriya D Mehta  5 , Maximo O Brito  6
Affiliations

Birth Defects and Long-Term Neurodevelopmental Abnormalities in Infants Born During the Zika Virus Epidemic in the Dominican Republic

Raquel Pimentel et al. Ann Glob Health. .

Abstract

Background: When acquired during pregnancy, Zika virus (ZIKV) infection can cause substantial fetal morbidity, however, little is known about the long-term neurodevelopmental abnormalities of infants with congenital ZIKV exposure without microcephaly at birth.

Methods: We conducted a cross sectional study to characterize infants born with microcephaly, and a retrospective cohort study of infants who appeared well at birth, but had possible congenital ZIKV exposure. We analyzed data from the Dominican Ministry of Health's (MoH) National System of Epidemiological Surveillance. Neurodevelopmental abnormalities were assessed by pediatric neurologists over an 18-month period using Denver Developmental Screening Test II.

Results: Of 800 known live births from 1,364 women with suspected or confirmed ZIKV infection during pregnancy, 87 (11%) infants had confirmed microcephaly. Mean head circumference (HC) at birth was 28.1 cm (SD ± 2.1 cm) and 41% had a HC on the zero percentile for gestational age. Of 42 infants with possible congenital ZIKV exposure followed longitudinally, 52% had neurodevelopmental abnormalities, including two cases of postnatal onset microcephaly, during follow-up. Most abnormalities resolved, though two infants (4%) had neurodevelopmental abnormalities that were likely associated with ZIKV infection and persisted through 15-18 months.

Conclusions: In the DR epidemic, 11% of infants born to women reported to the MoH with suspected or confirmed ZIKV during pregnancy had microcephaly. Some 4% of ZKV-exposed infants developed postnatal neurocognitive abnormalities. Monitoring of the cohort through late childhood and adolescence is needed.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Epidemic curve of ZIKV cases among pregnant women and confirmed microcephaly cases in Dominican Republic, 2016–2017.
Figure 2
Figure 2
Cases of microcephaly by region, Dominican Republic 2016–2017.
Figure 3
Figure 3
The distribution of weight, height, and head circumference among infant girls and boys.
Figure 4
Figure 4
Proportional Venn Diagram of neurodevelopmental and DDST domain abnormalities.
Figure 5
Figure 5
Sequence plot showing neurodevelopmental abnormalities by clinic visit.
See this image and copyright information in PMC

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