Intended for healthcare professionals


One in seven children born to mothers who had Zika infection has health problems

BMJ 2018; 362 doi: (Published 09 August 2018) Cite this as: BMJ 2018;362:k3477
  1. Susan Mayor
  1. London

One in seven children born to women who had Zika virus infection when they were pregnant have Zika associated birth defects or neurodevelopmental abnormalities, an analysis that followed up children at one year old has found.1

“Careful monitoring and evaluation of children born to mothers with evidence of Zika infection during pregnancy is essential for ensuring early detection of possible disabilities and early referral to intervention services,” the report authors said.

The study analysed data for 1450 children aged one year and older born to mothers with laboratory evidence of confirmed or possible Zika virus infection during pregnancy and with follow-up care reported in the US Zika and Infant Registry. This registry currently monitors outcomes of around 7300 pregnancies, including 4800 from US territories and associated states, including Puerto Rico.

Results, reported in the latest Morbidity and Mortality Weekly Report from the US Centers for Disease Control and Prevention, showed that 87 (6%) of the children included in the analysis had at least one birth defect associated with Zika, including brain and eye anomalies, identified during their follow-up care.

Nearly one in 10 (136; 9%) of the children had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection, including hearing or movement abnormalities, seizures, and congenital contractures. And 20 children (1%) had both birth defects and neurodevelopmental abnormalities.

Overall, the findings showed that one in seven (14%) of the children had Zika associated birth defects, neurodevelopmental abnormalities, or both.

“Given that most children did not have evidence of all recommended evaluations, additional anomalies might not have been identified,” the authors said. Only 76% of the children had documented evidence of developmental screening or evaluation, 60% had postnatal neuroimaging, 48% had detailed screening of hearing, and 36% had ophthalmologic evaluation.

“Given the potential benefits from interventions during early critical periods of infant development, healthcare providers should share information on maternal Zika virus exposure and closely monitor child health and development,” they concluded.


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