Children exposed to in utero zika virus infection face neurodevelopmental delays, finds study
A recent study published in the Pediatrics journal highlighted the long-term impacts of Zika virus (ZIKV) infections during pregnancy which revealed a significant risk of neurodevelopmental delays in children exposed to the virus in utero. The research was conducted between 2018 and 2022 and illuminates the pressing need for improved prenatal care and long-term monitoring of children exposed to ZIKV.
This retrospective-prospective matched cohort analysis, enrolled mother-infant pairs from Mato Grosso do Sul. This research compared those exposed to ZIKV during pregnancy with a control group of unexposed pairs. Clinical and epidemiological data from the Brazilian health surveillance system provided insight into the gestational period and neonatal outcomes, while children underwent assessments for both early congenital anomalies and long-term neurodevelopmental challenges.
The incidence risk ratio (IRR) for adverse outcomes in ZIKV-exposed children was 2.7 times higher than that of the control group. The risks of motor and cognitive delays were particularly concerning. Motor development delays were 3.4 times more likely (95% CI, 1.2–9.6) in exposed children, while cognitive delays were 4.7 times more likely (95% CI, 1.7–13.0).
The timing of maternal infection played a critical role in determining the risk severity. When ZIKV infection occurred during the first trimester, the odds of adverse outcomes in children surged to an 11.2 times greater (95% CI, 3.6–35.0) when compared to infections in the third trimester. Nearly half (44%) of first-trimester infections resulted in at least one adverse event in the child.
The study also addressed the risks of congenital Zika syndrome (CZS), characterized by severe brain and skull abnormalities, among other complications. However, even in children without CZS, the risk of neurodevelopmental delays persisted by emphasizing that the effects of ZIKV exposure can be subtle but profound.
Overall, this study called for increased vigilance in monitoring and supporting ZIKV-exposed children, even if no immediate congenital anomalies are observed at birth. Early interventions could reduce the long-term impact of these developmental challenges. This study highlights the urgent need for public health initiatives to prevent ZIKV transmission, especially during pregnancy.
Reference:
Venancio, F. A., Quilião, M. E., Gabeira, S. C. de O., Carvalho, A. T. de, Leite, S. H. dos S., de Lima, S. M. B., Alves, N. dos S., Moura, L. da C., Schwarcz, W. D., Azevedo, A. de S., Demarchi, L. H. F., Zardin, M. C. S. U., Lichs, G. G. de C., Taira, D. L., Fernandes, W. de S., Alves, N. O., Arrua, A. E. C., Nascimento, A. I. do, Mareto, L. K., … Oliveira, E. F. de. (2025). Early and long-term adverse outcomes of in utero Zika exposure. Pediatrics. https://doi.org/10.1542/peds.2024-067552
