Neurodevelopment in Normocephalic Children Exposed to Zika Virus in Utero with No Observable Defects at Birth: A Systematic Review with Meta-Analysis

Elena Marbán-Castro, Laia J. Vazquez Guillamet, Percy Efrain Pantoja, Aina Casellas, Lauren Maxwell, Sarah B. Mulkey, Clara Menéndez and Azucena Bardají
Additional contact information
Elena Marbán-Castro: ISGlobal, Hospital Clínic—Universitat de Barcelona, 132 Rosselló Street, 08036 Barcelona, Spain
Laia J. Vazquez Guillamet: ISGlobal, Hospital Clínic—Universitat de Barcelona, 132 Rosselló Street, 08036 Barcelona, Spain
Percy Efrain Pantoja: Health Services Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
Aina Casellas: ISGlobal, Hospital Clínic—Universitat de Barcelona, 132 Rosselló Street, 08036 Barcelona, Spain
Lauren Maxwell: Heidelberg Institute for Global Health, Heidelberg University, 69120 Heidelberg, Germany
Sarah B. Mulkey: Children’s National Hospital, Washington, DC 20010, USA
Clara Menéndez: ISGlobal, Hospital Clínic—Universitat de Barcelona, 132 Rosselló Street, 08036 Barcelona, Spain
Azucena Bardají: ISGlobal, Hospital Clínic—Universitat de Barcelona, 132 Rosselló Street, 08036 Barcelona, Spain

IJERPH, 2022, vol. 19, issue 12, 1-24

Abstract: Zika virus (ZIKV) infection during pregnancy is a cause of pregnancy loss and multiple clinical and neurological anomalies in children. This systematic review aimed to assess the effect of ZIKV exposure in utero on the long-term neurodevelopment of normocephalic children born to women with ZIKV infection in pregnancy. This review was conducted according to the PRISMA guidelines for systematic reviews and meta-analyses. We performed a random effects meta-analysis to estimate the cross-study prevalence of neurodevelopmental delays in children using the Bayley Scales for Infant and Toddler Development (BSID-III). The risk of bias was assessed using Cochrane’s Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Full-text reviews were performed for 566 articles, and data were extracted from 22 articles corresponding to 20 studies. Nine articles including data from 476 children found 6.5% (95% CI: 4.1–9.3) of infants and children to have any type of non-language cognitive delay; 29.7% (95% CI: 21.7–38.2) to have language delay; and 11.5% (95% CI: 4.8–20.1) to have any type of motor delay. The pooled estimates had a high level of heterogeneity; thus, results should be interpreted with caution. Larger prospective studies that include a non-exposed control group are needed to confirm whether ZIKV exposure in utero is associated with adverse child neurodevelopmental outcomes.

Keywords: Zika; neurodevelopment; language; cognitive; motor; delay; normocephalic (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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