School-age child neurodevelopment following antenatal Zika virus exposure

Authors

Sarah B. Mulkey, Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA. sbmulkey@childrensnational.org.
Regan Andringa-Seed, Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA.
Elizabeth Corn, Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA.
Meagan E. Williams, Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA.
Margarita Arroyave-Wessel, Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA.
Robert H. Podolsky, Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, USA.
Colleen Peyton, Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Michael E. Msall, Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, University of Chicago Medicine, Chicago, IL, USA.
Carlos Cure, BIOMELab, Barranquilla, Atlántico, Colombia.
Madison M. Berl, Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Document Type

Journal Article

Publication Date

3-19-2025

Journal

Pediatric research

DOI

10.1038/s41390-025-03981-7

Abstract

BACKGROUND: Children exposed antenatally to Zika virus (ZIKV) during the 2015-2016 epidemic are now in school; little is known about their neurodevelopment at this age. The objective was to evaluate neurodevelopment of ZIKV-exposed Colombian children compared to non-exposed controls at ages 5-6. METHODS: In total, 48 normocephalic children with antenatal ZIKV exposure (Cases) were recruited for a longitudinal cohort study in Atlántico, Colombia. Two age-matched control groups of 118 non-ZIKV-exposed children were recruited from same communities as Cases: 63 born before ZIKV epidemic but experienced COVID-19-related school entry delays, and 55 born post-ZIKV epidemic but started school on time. Multi-domain neurodevelopment was assessed at 5-6 years using standardized measures. Standard regression and proportional odds models were used to compare outcomes. P values were adjusted using the Benjamini-Hochberg false discovery rate (FDR) (p < 0.05). RESULTS: There were no differences in age at assessment between groups. Case Full-Scale IQ scores were lower than both control groups (p = 0.002), driven by visual reasoning (p < 0.001). Controls with school entry delay had more executive control problems and lower adaptive functioning skills than Cases and Controls without school entry delay. CONCLUSIONS: ZIKV-exposed children have lower cognitive performance compared to controls. Early childhood experiences can affect pediatric outcomes research. IMPACT: Normocephalic ZIKV-exposed children have lower full-scale IQ than their unexposed peers from the same communities. Normocephalic children with antenatal ZIKV exposure have differences in neurodevelopment that can impact them long-term. There is a need for continued follow-up of children with antenatal ZIKV exposure to determine long-term effects on higher-order areas of cognitive function.

APA Citation

Mulkey, Sarah B.; Andringa-Seed, Regan; Corn, Elizabeth; Williams, Meagan E.; Arroyave-Wessel, Margarita; Podolsky, Robert H.; Peyton, Colleen; Msall, Michael E.; Cure, Carlos; and Berl, Madison M., "School-age child neurodevelopment following antenatal Zika virus exposure" (2025). GW Authored Works. Paper 6792.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6792

Department

Neurology