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EXAMINING THE ASSOCIATION OF SOCIOECONOMIC POSITION WITH MICROCEPHALY AND DELAYED CHILDHOOD NEURODEVELOPMENT AMONG CHILDREN WITH PRENATAL ZIKA VIRUS EXPOSURE
Congenital Zika syndrome
Health equity
Microcephaly
Neurodevelopment
Socioeconomic position
Author
Affilliation
London School of Hygiene & Tropical Medicine. Faculty of Infectious and Tropical Diseases. Department of Disease Control. London, UK / London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK / University of Bristol. Bristol Medical School. Population Health Sciences. MRC Integrative Epidemiology Unit. Bristol, UK.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil / London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
University of California. Pediatrics. Los Angeles, CA, USA.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil / London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
University of California. Pediatrics. Los Angeles, CA, USA.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Abstract
Increased rates of Zika virus have been identified in economically deprived areas in Brazil at the population level; yet, the implications of the interaction between socioeconomic position and prenatal Zika virus exposure on adverse neurodevelopmental outcomes remains insufficiently evaluated at the individual level. Using data collected between September 2015 and September 2019 from 163 children with qRT-PCR and/or IgM-confirmed prenatal exposure to Zika virus participating in a prospective cohort study in Rio de Janeiro, Brazil (NCT03255369), this study evaluated the relationships of socioeconomic indicators with microcephaly at birth and Bayley-III neurodevelopmental scores during the early life course. Adjusted logistic regression models indicated increased odds of microcephaly in children born to families with lower household income (OR, 95% CI: 3.85, 1.43 to 10.37) and higher household crowding (OR, 95% CI: 1.83, 1.16 to 2.91), while maternal secondary and higher education appeared to have a protective effect for microcephaly compared to primary education (OR, 95% CI: 0.33, 0.11 to 0.98 and 0.10, 0.03 to 0.36, respectively). Consistent with these findings, adjusted linear regression models indicated lower composite language (-10.78, 95% CI: -19.87 to -1.69), motor (-10.45, 95% CI: -19.22 to -1.69), and cognitive (-17.20, 95% CI: -26.13 to -8.28) scores in children whose families participated in the Bolsa Família social protection programme. As such, the results from this investigation further emphasise the detrimental effects of childhood disadvantage on human health and development by providing novel evidence on the link between individual level socioeconomic indicators and microcephaly and delayed early life neurodevelopment following prenatal Zika virus exposure.
Keywords
Zika virusCongenital Zika syndrome
Health equity
Microcephaly
Neurodevelopment
Socioeconomic position
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