Neurodevelopmental Follow-Up in Children with Intrauterine and Perinatal Exposure to Chikungunya Virus

Federal University of the State of Rio de Janeiro. Gaffrée and Guinle University Hospital. Department of Neonatal Intensive Care. Rio de Janeiro, RJ, Brazil.
University of California. David Geffen School of Medicine. Division of Pediatric Infectious Diseases. Los Angeles, CA, USA.
Oswaldo Cruz Foundation. Fernandes Figueira National Institute of Children's, Adolescents', and Women's Health. Department of Clinical Research. Rio de Janeiro, RJ, Brazil.
Federal University of the State of Rio de Janeiro. Gaffrée and Guinle University Hospital. Department of Neonatal Intensive Care. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Federal University of the State of Rio de Janeiro. Gaffrée and Guinle University Hospital. Department of Physiotherapy and Occupational Therapy. Rio de Janeiro, RJ, Brazil.
Heidelberg University. University Hospital Heidelberg. Department of Child and Adolescent Psychiatry. Heidelberg, Germany / University Medical Center Göttingen. German Center for Child and Adolescent Health and Leibniz Science Campus Primate Cognition. Child and Adolescent Psychiatry and Psychotherapy. Göttingen, Germany / Medical University of Graz. Division of Phoniatrics. Interdisciplinary Developmental Neuroscience. Graz, Austria.
University Medical Center Göttingen. German Center for Child and Adolescent Health and Leibniz Science Campus Primate Cognition. Child and Adolescent Psychiatry and Psychotherapy. Göttingen, Germany.
Medical University of Graz. Division of Phoniatrics. Interdisciplinary Developmental Neuroscience. Graz, Austria.
Heidelberg University. University Hospital Heidelberg. Department of Child and Adolescent Psychiatry. Heidelberg, Germany / University Medical Center Göttingen. German Center for Child and Adolescent Health and Leibniz Science Campus Primate Cognition. Child and Adolescent Psychiatry and Psychotherapy. Göttingen, Germany / Medical University of Graz. Division of Phoniatrics. Interdisciplinary Developmental Neuroscience. Graz, Austria.
University of California. Institute of the Environment and Sustainability. Los Angeles, CA, USA.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.

Abstract

Objective: To investigate the effects of intrauterine and perinatal exposure to chikungunya virus (CHIKV) on neurodevelopment in infants and toddlers. Study design: We conducted a cohort study comparing children with intrauterine or perinatal exposure to maternal CHIKV infection with unexposed controls in Rio de Janeiro, Brazil. Neurodevelopment was assessed with General Movement Assessments in the first 6 months of life, and the Bayley-III Scales of Infant and Toddler Development and Modified Checklist for Autism in Toddlers for older children. Developmental delay (DD) was defined as a Bayley score less than 70 and risk of DD as a score less than 85. Results: Among 60 children exposed to intrauterine or perinatal CHIKV, 20 (33%) had laboratory confirmation of CHIKV infection by reverse transcription polymerase chain reaction or immunoglobulin M serology and 40 did not; 44 exposed children (15 infected and 29 uninfected) had General Movement Assessment performed, with 19% having suboptimal or abnormal results. At 11-42 months of age, 35 exposed children and 78 unexposed controls had Bayley-III assessments. Compared with controls, exposed children had higher rates of DD (7 [20%] vs 2 [3%], P = .004) driven by the language domain, and greater risk of DD driven by motor and cognitive domains scores (10 [29%] vs 10 [13%], P = .03 and 8 [23%] vs 5 [6%], P = .02, respectively). Eight of 35 (23%), CHIKV exposed children screened positive for autism spectrum disorder. CHIKV-exposed uninfected children had 2 (9.5%) cases of DD and 5 (23.8%) cases of autism spectrum disorder. Conclusions: Abnormal neurodevelopmental results were seen in both infected and uninfected children with intrauterine or perinatal CHIKV exposure. Infant neurodevelopment monitoring should be considered following exposure to maternal CHIKV infection in pregnancy to facilitate early interventions and to mitigate neurodevelopmental sequelae.

Keywords

Chikungunya
Neonatal encephalopathy
Neonatal neurodevelopmental delay
Newborn
Vertical transmission

Publisher

Elsevier

Citation

FERREIRA, Fátima Cristiane Pinho de Almeida Di Maio et al. Neurodevelopmental Follow-Up in Children with Intrauterine and Perinatal Exposure to Chikungunya Virus. The Journal of Pediatrics, v. 279, p. 1-42, Jan. 2025.

DOI

10.1016/j.jpeds.2025.114477

ISSN

0022-3476

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/68707

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Copyright

Restricted access

Embargo date

2030-12-31

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