Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool

Detalhes bibliográficos
Autor(a) principal: Einspieler, Christa
Data de Publicação: 2019
Outros Autores: Utsch, Fabiana, Brasil, Patricia, Aizawa, Carolina Y. Panvequio, Peyton, Colleen, Hasue, Renata Hydee, Genovesi, Fernanda Rançoso, Damasceno, Luana, Moreira, Maria Elisabeth, Adachi, Kristina, Marschik, Peter B., Nielsen-Saines, Karin
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/31842
Resumo: Medical University of Graz. Interdisciplinary Developmental Neuroscience. Graz, Austria.
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spelling Einspieler, ChristaUtsch, FabianaBrasil, PatriciaAizawa, Carolina Y. PanvequioPeyton, ColleenHasue, Renata HydeeGenovesi, Fernanda RançosoDamasceno, LuanaMoreira, Maria ElisabethAdachi, KristinaMarschik, Peter B.Nielsen-Saines, Karin2019-02-22T13:36:14Z2019-02-22T13:36:14Z2019EINSPIELER, Christa et al. Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool. Jama Network Open, v. 2, n. 1, p. 1-13, 2019.2574-3805https://www.arca.fiocruz.br/handle/icict/3184210.1001/jamanetworkopen.2018.7235engAmerican Medical AssociationAssociation of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment toolinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleMedical University of Graz. Interdisciplinary Developmental Neuroscience. Graz, Austria.Rede SARAH de Hospitais de Reabilitação. Reabilitação Infantil. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.University of São Paulo. Faculty of Medicine. Department of Physical Therapy, Communication Sciences & Disorders, and Occupational Therapy. São Paulo, SP, Brazil.Northwestern University. Department of Physical Therapy and Human Movement Science. Chicago, IL, USA.University of São Paulo. Faculty of Medicine. Department of Physical Therapy, Communication Sciences & Disorders, and Occupational Therapy. São Paulo, SP, Brazil.University of São Paulo. Faculty of Medicine. Department of Physical Therapy, Communication Sciences & Disorders, and Occupational Therapy. São Paulo, SP, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Pediatria. Rio de Janeiro, RJ, Brasil.University of California. David Geffen School of Medicine. Department of Pediatrics. Division of Pediatric Infectious Diseases. Los Angeles, CA, USA.Medical University of Graz. Interdisciplinary Developmental Neuroscience. Graz, Austria / University Medical Center Göttingen. Department of Child and Adolescent Psychiatry and Psychotherapy. Interdisciplinary Developmental Neuroscience. Göttingen, Germany / Karolinska Institutet. Center of Neurodevelopmental Disorders (KIND). Department of Women’s and Children’s Health. Stockholm, Sweden.University of California. David Geffen School of Medicine. Department of Pediatrics. Division of Pediatric Infectious Diseases. Los Angeles, CA, USA.IMPORTANCE: There is an urgent need to assess neurodevelopment in Zika virus (ZIKV)–exposed infants. OBJECTIVES: To perform general movement assessment (GMA) at 9 to 20 weeks’ postterm age and to evaluate whether the findings are associated with neurodevelopmental outcomes at age 12 months in infants prenatally exposed to acute maternal illness with rash in Brazil during the ZIKV outbreak and in age-matched controls. DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, infants prenatally exposed to acute maternal illness with rash were recruited at medical institutions in Rio de Janeiro and Belo Horizonte, Brazil, from February 1, 2016, to April 30, 2017, while infants without any exposure to maternal illness originated from the Graz University Audiovisual Research Database for the Interdisciplinary Analysis of Neurodevelopment. Participants were 444 infants, including 76 infants without congenital microcephaly, 35 infants with microcephaly, and 333 neurotypical children matched for sex, gestational age at birth, and age at GMA. MAIN OUTCOMES AND MEASURES: General movement assessment performed at 9 to 20 weeks’ postterm age, with negative predictive value, positive predictive value, sensitivity, and specificity generated, as well as clinical, neurologic, and developmental status (Bayley Scales of Infant and Toddler Development, Third Edition [Bayley-III] scores) at age 12 months. Motor Optimality Scores were generated based on the overall quality of the motor repertoire. Adverse outcomes were defined as a Bayley-III score less than 2 SD in at least 1 domain, a score less than 1 SD in at least 2 domains, and/or atypical neurologic findings. RESULTS: A total of 444 infants were enrolled, including 111 children prenatally exposed to a maternal illness with rash and 333 children without any prenatal exposure to maternal illness (57.7% male and mean [SD] age, 14 [2] weeks for both groups); 82.1% (46 of 56) of ZIKV-exposed infants without congenital microcephaly were healthy at age 12 months. Forty-four of 46 infants were correctly identified by GMA at 3 months, with a negative predictive value of 94% (95% CI, 85%-97%). Seven of 10 ZIKV-exposed children without microcephaly with adverse neurodevelopmental outcomes were identified by GMA. The GMA positive predictive value was 78% (95% CI, 46%-94%), sensitivity was 70% (95% CI, 35%-93%), specificity was 96% (95% CI, 85%-99%), and accuracy was 91% (95% CI, 80%-97%). Children with microcephaly had bilateral spastic cerebral palsy; none had normal movements. The Motor Optimality Score differentiated outcomes: the median Motor Optimality Score was 23 (interquartile range [IQR], 21-26) in children with normal development, 12 (IQR, 8-19) in children with adverse outcomes, and 5 (IQR, 5-6) in children with microcephaly, a significant difference (P = .001). CONCLUSIONS AND RELEVANCE: This study suggests that although a large proportion of ZIKV-exposed infants without microcephaly develop normally, many do not. The GMA should be incorporated into routine infant assessments to enable early entry into targeted treatment programs.Zika virusPrenatal Zika virus infectioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/31842/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALve_Einspieler_Christa_etal_INI_2019.pdfve_Einspieler_Christa_etal_INI_2019.pdfapplication/pdf967108https://www.arca.fiocruz.br/bitstream/icict/31842/2/ve_Einspieler_Christa_etal_INI_2019.pdf5916a5ef5f16dfba6dc7329b765ca96eMD52TEXTve_Einspieler_Christa_etal_INI_2019.pdf.txtve_Einspieler_Christa_etal_INI_2019.pdf.txtExtracted texttext/plain53655https://www.arca.fiocruz.br/bitstream/icict/31842/3/ve_Einspieler_Christa_etal_INI_2019.pdf.txt22bf8ec31d4171ceebf1481b53eb2d82MD53icict/318422019-02-23 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dc.title.pt_BR.fl_str_mv Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
title Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
spellingShingle Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
Einspieler, Christa
Zika virus
Prenatal Zika virus infection
title_short Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
title_full Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
title_fullStr Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
title_full_unstemmed Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
title_sort Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool
author Einspieler, Christa
author_facet Einspieler, Christa
Utsch, Fabiana
Brasil, Patricia
Aizawa, Carolina Y. Panvequio
Peyton, Colleen
Hasue, Renata Hydee
Genovesi, Fernanda Rançoso
Damasceno, Luana
Moreira, Maria Elisabeth
Adachi, Kristina
Marschik, Peter B.
Nielsen-Saines, Karin
author_role author
author2 Utsch, Fabiana
Brasil, Patricia
Aizawa, Carolina Y. Panvequio
Peyton, Colleen
Hasue, Renata Hydee
Genovesi, Fernanda Rançoso
Damasceno, Luana
Moreira, Maria Elisabeth
Adachi, Kristina
Marschik, Peter B.
Nielsen-Saines, Karin
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Einspieler, Christa
Utsch, Fabiana
Brasil, Patricia
Aizawa, Carolina Y. Panvequio
Peyton, Colleen
Hasue, Renata Hydee
Genovesi, Fernanda Rançoso
Damasceno, Luana
Moreira, Maria Elisabeth
Adachi, Kristina
Marschik, Peter B.
Nielsen-Saines, Karin
dc.subject.en.pt_BR.fl_str_mv Zika virus
Prenatal Zika virus infection
topic Zika virus
Prenatal Zika virus infection
description Medical University of Graz. Interdisciplinary Developmental Neuroscience. Graz, Austria.
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-02-22T13:36:14Z
dc.date.available.fl_str_mv 2019-02-22T13:36:14Z
dc.date.issued.fl_str_mv 2019
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv EINSPIELER, Christa et al. Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool. Jama Network Open, v. 2, n. 1, p. 1-13, 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/31842
dc.identifier.issn.pt_BR.fl_str_mv 2574-3805
dc.identifier.doi.none.fl_str_mv 10.1001/jamanetworkopen.2018.7235
identifier_str_mv EINSPIELER, Christa et al. Association of infants exposed to prenatal Zika virus infection with their clinical, neurologic, and developmental status evaluated via the general movement assessment tool. Jama Network Open, v. 2, n. 1, p. 1-13, 2019.
2574-3805
10.1001/jamanetworkopen.2018.7235
url https://www.arca.fiocruz.br/handle/icict/31842
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv American Medical Association
publisher.none.fl_str_mv American Medical Association
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
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reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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