University of Wisconsin–Madison Medical College of Wisconsin

Neurodevelopmental Screening Tests Outcomes of Children in Wisconsin With a Prenatal History of Travel to Zika Virus Endemic Regions During 2015-2018: A Retrospective Case-Control Study

Sabrina A. Kabakov, OTD;* Rachel V. Spanton*; Elaina Razo; Erik Sanson; Christelle Cayton; Emmy Wanjiku; Jens Eickhoff, PhD; Karla K. Ausderau, OTR, PhD; Emma L. Mohr, MD, PhD

WMJ. 2024;123(6):562-568.

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ABSTRACT

Background: Children with prenatal Zika virus exposure are at an increased risk of developing neurodevelopmental deficits in early childhood. Travel to Zika virus-endemic regions during pregnancy elevates the risk of offspring developing complications. This study examined developmental outcomes of children from Wisconsin with maternal or partner travel history to Zika virus-endemic regions during pregnancy compared to gestation and age-matched controls.

Methods: A retrospective chart review compared outcomes of cases (n = 181) with prenatal travel history to Zika virus-endemic regions to gestational and birth date-matched controls (n = 172) up to 7 years old. We reported Zika virus testing and travel, birth outcomes, standardized developmental screening tests, and specialist referral rates.

Results: There were no differences in referral rates and standardized developmental screening test outcomes, but cases tended to have more referrals for early intervention compared to the controls (P = 0.059). One Zika virus-positive case was identified with complications surrounding birth, and 2.2% of children had documentation in their health records noting potential Zika virus exposure. Regardless of groups, limited referrals were made at 9 (0%), 18 (60%), and 24 (40%) months based on Ages and Stages Questionnaire-version 3 (ASQ-3) recommendations.

Conclusions: This study found similar developmental screening outcomes and referral rates between groups. Longitudinal care of children whose mothers traveled to Zika virus-endemic regions could be improved with better documentation of prenatal Zika virus exposure in the child’s medical record, use of standardized developmental screening tools at every recommended well-child visit, and referral when developmental screening test scores are low.


Author Affiliations: Department of Pediatrics, University of Wisconsin (UW) School of Medicine and Public Health (SMPH), Madison, Wisconsin (Kabakov, Spanton, Razo, Sanson, Cayton, Wanjiku, Mohr); Department of Kinesiology, Occupational Therapy Program, UW–Madison, Madison, Wisconsin (Kabakov, Ausderau); Department of Biostatistics and Medical Informatics, UW SMPH, Madison, Wisconsin (Eickhoff); Waisman Center, UW–Madison, Madison, Wisconsin (Ausderau); Department of Medical Microbiology and Immunology, UW SMPH, Madison, Wisconsin (Mohr). *Denotes co-first authors.
Corresponding Author: Emma Mohr, 600 Highland Ave, Madison WI 53792, phone 608.265.5107, email emohr2@wisc.edu, ORCID ID 0000-0003-0742-305X
Acknowledgments: The authors wish to thank Donovin Widmann, a medical student who supported the data acquisition of this chart review; the members of Dr Mohr and Dr Ausderau’s lab for supporting this work; Dr. Kathleen Antony, a maternal-fetal medicine specialist, who provided them with the paper records; and Ancilla Partners, Inc for its comprehensive birth registry data of PeriData.net.
Funding/Support: This work was supported by departmental funding to Dr Mohr, National Institutes of Health (NIH) funding (K08AI139341) to Dr Mohr, and the UW School of Medicine and Public Health Shapiro Summer Research Program. The UW–Madison Clinical and Health Informatics Institute was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS) grant UL1TR002373.
Financial Disclosures: None declared.
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