139 - Developmental Outcome in Early Childhood After In-Utero ZIKV Exposure in Children Without Congenital Zika Syndrome

Poster Number: 139
Publication Number: 139.111

Sarah B. Mulkey, Children's National Hospital, Washington, DC, United States; Colleen Peyton, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Emily Ansusinha, Children's National Health System, Washington, DC, United States; Elizabeth A. Corn, Children's National Health System, DC, DC, United States; Margarita Arroyave-Wessel, Children's National Health System, Washington, DC, United States; Anqing Zhang, George Washington University School of Medicine and Health Sciences, D.C., DC, United States; Cara L. Biddle, Children's National Hospital, Washington, DC, United States; Andres F. Cure, Universidad Autonoma del Caribe, barranquilla, Atlantico, Colombia; Daniela Cure, Universidad Del Norte, Barranquilla, Atlantico, Colombia; Adre du Plessis, George Washington University School of Medicine and Health Sciences, Washington, DC, United States; Roberta L. DeBiasi, Children's National Hospital and The George Washington University School of Medicine, Washington, DC, United States; Michael E. Msal, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Carlos A. Cure, biomelab, Barranquilla, Atlantico, Colombia

Background: Children with in-utero Zika virus (ZIKV) exposure without congenital Zika syndrome (CZS) are at risk for delayed neurodevelopmental performance to 18 months of age (Mulkey et al, JAMA Pediatr 2019). Since these children are only now reaching age 3-4 years, early childhood outcome for antenatal ZIKV exposure has not yet been established.

Objective: Determine if children exposed to ZIKV in-utero who are normal appearing at birth have abnormal neurodevelopment in early childhood.

Design/Methods: We performed a prospective study of ZIKV-exposed children and unexposed controls in Sabanalarga, Colombia. 70 cases from our cohort were eligible (did not have CZS and seen prenatally through 18 months of age). Control children were born before Zika arrival to Colombia. Child development was assessed by parent questionnaires (Pediatric Evaluation of Disability Inventory [PEDI-CAT], Behavior Rating Inventory of Executive Function [BRIEF-P]), and objective child evaluations, Bracken School Readiness Assessment (BRSA) and Movement Assessment Battery for Children (MABC) for gross and fine motor skills. Parent education, occupation and child medical history were noted. Due to COVID-19, the US team attended by Zoom Telehealth in real time. Videos of BRSA and MABC were used to score. Scores were scaled for age per test manuals, except BRSA. Scores between cases and controls were compared using t-test or Mann-Whitney when normality is violated.

Results: 55/70 (79%) cases were evaluated at a mean (SD) of 3.6 (.4) years; 70 controls were evaluated at 5.2 (.2) years (Table). Family demographics have no significant difference between groups. Cases had lower mobility and responsibility PEDI-CAT scores, but higher social/cognitive and daily activities (all, PConclusion(s): Children with in-utero ZIKV exposure without CZS show good progression of developmental skills in early childhood. Executive and cognitive function domains may be areas affected that require continued evaluation and direct age comparison to controls. Further study to school-age is necessary.
Child assessment results ZIKV-exposed children vs. non-exposed controlsAbbreviations: BREIF-P= Behavior Rating Inventory of Executive Function; BRSA= Bracken School Readiness Assessment; MABC= Movement Assessment Battery for Children; PEDI-CAT= Pediatric Evaluation of Disability Inventory