NEJM, December 13, 2018

Lopes Moreira ME, Nielsen-Saines K, Brasil P, Kerin T, Damasceno L, Pone M, Carvalho LMA, Pone SM, Vasconcelos Z, Ribeiro IP, Zin AA, Tsui I, Adachi K, Gaw SL, Halai UA, Salles TS, da Cunha DC, Bonaldo MC, Raja Gabaglia C, Guida L, Malacarne J, Costa RP, Gomes SC Jr, Reis AB, Soares FVM, Hasue RH, Aizawa CYP, Genovesi FF, Aibe M, Einspieler C, Marschik PB, Pereira JP Jr, Portari EA, Janzen C, Cherry JD


During the Zika virus (ZIKV) epidemic in Rio de Janeiro from September 2015 through June 2016, a prospective cohort study involving symptomatic pregnant women who had ZIKV infection confirmed by reverse-transcriptase–polymerase-chain-reaction assay was established. The study was approved by the institutional review boards at Fundação Oswaldo Cruz in Rio de Janeiro and the University of California, Los Angeles, and all the women provided written informed consent for themselves and their children.

A total of 182 children who were exposed to ZIKV in utero were followed longitudinally with specialized testing (Fig. S1 in the Supplementary Appendix, available with the full text of this letter at Of these children, 131 (72%) were brought by their parents for at least one of the following evaluations: brain imaging (in 115 children), complete eye examinations (in 112),2 assessment with the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III) (in 104), and assessment of brain-stem auditory evoked response (in 49). Brain-imaging studies consisted of transfontanelle cerebral ultrasonography (in 98 children), computed tomography (in 25), magnetic resonance imaging (MRI) (in 47), or all of these tests; 45 children who underwent brain imaging (39%) underwent more than one type of study. Transfontanelle cerebral ultrasonography was usually performed first, and further imaging was performed according to clinical discretion.

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