近日，来自巴西的Maria Elisabeth Moreira研究组与美国加州大学洛杉矶分校的Karin Nielsen-Saines研究组，合作报道了寨卡病毒感染对儿童神经系统发育的后续影响。这一研究成果于2019年8月发表在国际学术期刊《自然—医学》上。

研究人员报告了自2015-2016年里约热内卢流行期间妊娠期PCR确认的孕妇寨卡病毒（ZIKV）感染以来216名婴儿的神经发育情况。通过婴幼儿发育Bayley量表（第三版，Bayley-III；认知、语言和运动领域）的评估，研究人员对146名儿童进行了评估，并利用神经发育问卷/神经系统测试评估了其余70名儿童。研究人员还进行了完整的眼睛检查（n=137）和听力评估（n=114）。31.5％的7至32个月的儿童存在低于平均水平的神经发育和/或异常的眼睛或听力评估。 在Bayley-III评估的儿童中，12％的儿童至少在一个领域的得分低于-2s.d. （得分<70；100±2s.d是得分范围）; 和28％的儿童在任一领域得分在-1到-2s.d之间（分数<85-70）。语言功能受影响最大，146名儿童中有35％低于平均水平。在女性儿童、足月儿、眼科检查正常的儿童和妊娠晚期母体感染的儿童中观察到改善的神经发育结果（P=0.01）。研究人员发现八个儿童中的两个儿童具有神经正常发育的小头畸形得到缓解，另外两个儿童出现继发性小头畸形，并在生下来第二年中三个先前健康的儿童出现自闭症谱系障碍。

附：英文原文

Title: Delayed childhood neurodevelopment and neurosensory alterations in the second year of life in a prospective cohort of ZIKV-exposed children

Author: Karin Nielsen-Saines, Patrcia Brasil, Tara Kerin, Zilton Vasconcelos, Claudia Raja Gabaglia, Luana Damasceno, Marcos Pone, Liege M. Abreu de Carvalho, Sheila M. Pone, Andrea A. Zin, Irena Tsui, Tania Regina S. Salles, Denise Cotrim da Cunha, Roozemerie Pereira Costa, Jociele Malacarne, Ana Beatriz Reis, Renata Hydee Hasue, Carolina Y. P. Aizawa, Fernanda F. Genovesi, Christa Einspieler, Peter B Marschik, Jos Paulo Pereira, Stephanie L. Gaw, Kristina Adachi, James D. Cherry, Zhiheng Xu, Genhong Cheng, Maria Elisabeth Moreira

Issue&Volume: Volume 25 Issue 8, August 2019

Abstract: We report neurodevelopmental outcomes in 216 infants followed since the time of PCR-confirmed maternal Zika virus (ZIKV) infection in pregnancy during the Rio de Janeiro epidemic of 20152016 (refs. 1,2). Neurodevelopment was assessed by Bayley Scales of Infant and Toddler Development, third edition (Bayley-III; cognitive, language and motor domains) in 146children and through neurodevelopment questionnaires/neurological examinations in 70remaining children. Complete eye exams (n=137) and hearing assessments (n=114) were also performed. Below-average neurodevelopment and/or abnormal eye or hearing assessments were noted in 31.5% of children between 7 and 32months of age. Among children assessed by Bayley-III, 12% scored below 2s.d. (score<70; a score of 1002s.d. is the range) in at least one domain; and 28% scored between 1 and 2s.d. in any domain (scores<8570). Language function was most affected, with 35% of 146children below average. Improved neurodevelopmental outcomes were noted in female children, term babies, children with normal eye exams and maternal infection later in pregnancy (P=0.01). We noted resolution of microcephaly with normal neurodevelopment in two of eight children, development of secondary microcephaly in two other children and autism spectrum disorder in three previously healthy children in the second year of life.

DOI: 10.1038/s41591-019-0496-1

Source: https://www.nature.com/articles/s41591-019-0496-1