Paradoxical results for children exposed to Zika

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<div data-thumb = "https://3c1703fe8d.site.internapcdn.net/newman/csz/news/tmb/2019/paradoxicalo.jpg" data-src = "https://3c1703fe8d.site.internapcdn.net/ newman / gfx / news / 2019 / paradoxicalo.jpg "data-sub-html =" Sequential neuroimaging of the fetus and newborn exposed to the Zika virus in utero. "Sarah B. Mulkey, MD, Ph.D., et al., Published in January 2019 in JAMA Pediatrics. Credit: JAMA network. Copyright American Medical Association, jamanetwork.com/journals/jamapediatrics/article-abstract/2716801 ">

In the midst of an unprecedented Zika crisis in Brazil, some glimmers of hope were perceived: some babies appeared normal at birth, free of devastating birth defects affecting other Brazilian children exposed to the virus. utero. But according to a study published online July 8, 2019, in Nature Medicine and an accompanying commentary co-authored by a national clinical researcher for children, the reality for infants exposed to Zika is much more complicated.

The authors of the study led by Karin Nielsen-Saines of the David Geffen School of Medicine followed in Rio de Janeiro 216 newborns exposed to the Zika virus during pregnancy, who carried out neurodevelopmental tests between 7 and 32 month. The mothers of these infants themselves had symptoms related to Zika, including rashes.

Although many children had normal badessments, 29% scored below average in at least one area of ​​neurodevelopment, including cognitive performance, fine and gross motor skills, and expressive language. Sarah B. Mulkey, MD, Ph.D., and a colleague write in a companion commentary posted online by Nature Medicine July 29, 2019.

The study authors discovered gradually higher risks of developmental abnormalities, hearing and eyes, depending on the onset of pregnancy at the time of infants' exposure . As the Zika virus has an affinity for immature neurons, even babies who were not born with microcephaly were still at risk for abnormalities.

It should be noted that 24 out of 49 (49%) infants with birth defects had normal test results in the second or third year of life. In contrast, 17 of 68 infants (25%) with normal birth badessments had underperformance tests or had hearing or vision abnormalities at the time of birth. 32 months.

"This work tracks babies born in 2015 and 2016. It is encouraging that some babies born with abnormalities tested in the normal range later in life, although it is unclear whether specific interventions help to achieve these positive results, "said Dr. Mulkey, Neonatal Fetal Neurologist in the Division of Fetal Medicine and Transition at the National Children's in Washington, DC" And it's quite shocking that babies who seemed normal to the birth develop abnormalities as a result of this early exposure to Zika. "

It is unclear to what extent the results apply to the vast majority of American women whose Zika infections were asymptomatic.

"This study adds to the growing body of research advocating for ongoing monitoring of children exposed to zika, even though their neurological examinations were rebaduring at birth," adds Dr. Mulkey. "As children exposed to Zika approach school age, it is essential to better characterize the potential implications for the education system and public health."