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Meta-Analysis
. 2022 Jun 14;19(12):7319.
doi: 10.3390/ijerph19127319.

Neurodevelopment in Normocephalic Children Exposed to Zika Virus in Utero with No Observable Defects at Birth: A Systematic Review with Meta-Analysis

Elena Marbán-Castro  1 , Laia J Vazquez Guillamet  1 , Percy Efrain Pantoja  2 , Aina Casellas  1 , Lauren Maxwell  3 , Sarah B Mulkey  4   5   6 , Clara Menéndez  1   7   8 , Azucena Bardají  1   7   8
Affiliations
Meta-Analysis

Neurodevelopment in Normocephalic Children Exposed to Zika Virus in Utero with No Observable Defects at Birth: A Systematic Review with Meta-Analysis

Elena Marbán-Castro et al. Int J Environ Res Public Health. .

Abstract

Zika virus (ZIKV) infection during pregnancy is a cause of pregnancy loss and multiple clinical and neurological anomalies in children. This systematic review aimed to assess the effect of ZIKV exposure in utero on the long-term neurodevelopment of normocephalic children born to women with ZIKV infection in pregnancy. This review was conducted according to the PRISMA guidelines for systematic reviews and meta-analyses. We performed a random effects meta-analysis to estimate the cross-study prevalence of neurodevelopmental delays in children using the Bayley Scales for Infant and Toddler Development (BSID-III). The risk of bias was assessed using Cochrane's Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Full-text reviews were performed for 566 articles, and data were extracted from 22 articles corresponding to 20 studies. Nine articles including data from 476 children found 6.5% (95% CI: 4.1-9.3) of infants and children to have any type of non-language cognitive delay; 29.7% (95% CI: 21.7-38.2) to have language delay; and 11.5% (95% CI: 4.8-20.1) to have any type of motor delay. The pooled estimates had a high level of heterogeneity; thus, results should be interpreted with caution. Larger prospective studies that include a non-exposed control group are needed to confirm whether ZIKV exposure in utero is associated with adverse child neurodevelopmental outcomes.

Keywords: Zika; cognitive; delay; language; motor; neurodevelopment; normocephalic.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Systematic review PRISMA flow diagram.
Figure 2
Figure 2
Forest plot of the prevalence of neurodevelopmental delays in children with prenatal ZIKV exposure and study authors. I²: variation in prevalence attributable to heterogeneit.; Cognitive domain: Differences between publications are low (I2 = 47.8%); thus, fixed-effects pooled prevalence was considered. Language domain: Differences between publications are low (I2 = 0.0%); thus, fixed-effects pooled prevalence was considered. Motor domain: Differences between publications are low (I2 = 17.5%); thus, fixed-effects pooled prevalence was considered.
See this image and copyright information in PMC

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