{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T06:04:38Z","timestamp":1792821878360,"version":"4.5.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01 HD094009"],"award-info":[{"award-number":["R01 HD094009"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R21AI137902"],"award-info":[{"award-number":["R21AI137902"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K24AI141744"],"award-info":[{"award-number":["K24AI141744"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R21 AI137902"],"award-info":[{"award-number":["R21 AI137902"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Neurodevelopmental outcomes of asymptomatic children exposed to Zika virus (ZIKV) in utero are not well characterized.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We prospectively followed 129 newborns without evidence of congenital Zika syndrome (CZS) up to 24 months of age. Participants were classified as ZIKV exposed or ZIKV unexposed. The Mullen Scales of Early Learning (MSEL) was administered in the participants\u2019 homes at 6, 12, 15, 18, 21, and 24 months of age by trained psychologists. Sociodemographic data, medical history, and infant anthropometry at birth were collected at each home visit. Our primary outcome was the Mullen Early Learning Composite Score (ECL) at 24 months of age between our 2 exposure groups. Secondary outcomes were differences in MSEL subscales over time and at 24 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 129 infants in whom exposure status could be ascertained, 32 (24.8%) met criteria for in utero ZIKV exposure and 97 (75.2%) did not. There were no differences in maternal age, maternal educational attainment, birthweight, or gestational age at birth between the 2 exposure groups. The adjusted means and standard errors (SEs) for the ELC score between the ZIKV-exposed children compared to ZIKV-unexposed children were 91.4 (SE, 3.1) vs 96.8 (SE, 2.4) at 12 months and 93.3 (SE, 2.9) vs 95.9 (SE, 2.3) at 24 months. In a longitudinal mixed model, infants born to mothers with an incident ZIKV infection (P = .01) and low-birthweight infants (&amp;lt;2500 g) (P = .006) had lower composite ECL scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this prospective cohort of children without CZS, children with in utero ZIKV exposure had lower neurocognitive scores at 24 months.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1833","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T04:13:47Z","timestamp":1609388027000},"page":"e146-e153","source":"Crossref","is-referenced-by-count":27,"title":["Neurodevelopmental Outcomes of Children Following In Utero Exposure to Zika in Nicaragua"],"prefix":"10.1093","volume":"72","author":[{"given":"Elizabeth M","family":"Stringer","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelin","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medical Science, National Autonomous University of Nicaragua at Le\u00f3n, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Blette","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Eduardo","family":"Toval Ruiz","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medical Science, National Autonomous University of Nicaragua at Le\u00f3n, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Boivin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Zepeda","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medical Science, National Autonomous University of Nicaragua at Le\u00f3n, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S A","family":"Stringer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlen","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medical Science, National Autonomous University of Nicaragua at Le\u00f3n, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiara","family":"Ortiz-Pujols","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, New York\u2013Presbyterian Hospital and Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itziar","family":"Familiar","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meylin","family":"Chavarria","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medical Science, National Autonomous University of Nicaragua at Le\u00f3n, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Goldman","sequence":"additional","affiliation":[{"name":"Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Bowman","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravinda","family":"de Silva","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Westreich","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, 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