Zika in Pregnant Women in Grenada: A 2-year Prospective Cohort Study

Background: In 2015, Zika virus (ZIKV) became the newest emerging public health threat, with resultant Congenital Zika Syndrome (CZS) in a subset of babies exposed to the virus in utero. A causal link between ZIKV and brain malformations has been established but the variability in extent of these disturbances and their impact on long term neurocognitive outcomes remains unknown. Longer-term follow-up of infants is required to assess any manifestations not detected at birth and ZIKV Spectrum Diseases and neurodevelopment assessments. This study aims to describe birth and pregnancy outcomes associated with ZIKV in a two-year prospective maternal-child cohort from Grenada.
Methods: We followed women exposed to ZIKV during pregnancy in Grenada and their offspring at prenatal, postpartum and one-year post-partum. We measured maternal and infant ZIKV and DENV exposure by highly sensitive and specific PGOLD testing. Mothers were interviewed regarding demographics and behaviors. Infants were assessed by physical examination and neurodevelopmental testing using the Oxford Neurodevelopment Assessment (OX-NDA), an internationally validated tool for the measurement of multiple neurodevelopment outcomes (cognition, language, motor skills, behavior, attentional problems and social-emotional reactivity).
Results: Maternal demographics and behaviors, PGOLD results, infant physical exam, and infant 12-month OX-NDA
Conclusions: Children born during or immediately following the ZIKV outbreak in Grenada are showing developmental lags in cognition, fine motor, and receptive language skills that might benefit from intervention. However, these results should be considered preliminary, as data collection efforts in the two-year-olds are still underway.