The impact of maternal flavivirus infections on fetal neurological outcomes: a scoping review

This scoping review examines the neurological effects of maternal flavivirus infection, specifically Zika virus (ZIKV), Dengue virus (DENV), and Yellow Fever virus (YFV), on fetal brain development. Inclusion criteria focused on studies involving maternal infection and neurodevelopmental outcomes in offspring up to five years of age. The review found that ZIKV, especially the African Strain, exhibited neuroviolence and pronounced fetal brain abnormalities. Despite the presence of transplacental maternal transfer, these antibodies did not fully prevent congenital malformations, including microcephaly and developmental delays. Diagnostic limitations, such as serological cross-reactivity, particularly in regions where multiple flaviviruses co-circulate, were shown to impede effective clinical management. Additionally, the review highlights stark disparities in health infrastructure and prenatal care in Latin America, where the burden of Congenital Zika Syndrome (CZS) is disproportionately high. Findings emphasize the need for strain-specific diagnostics and therapeutics, along with long-term cohort studies that integrate virological, immunological, and socio-environmental perspectives. Ultimately, this review underscores the urgent need for equitable public health strategies and continued interdisciplinary research to address the teratogenic risks associated with maternal flavivirus infections.