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婴儿和幼儿出现发育迟缓与突变有关。

Emergence of Developmental Delay in Infants and Toddlers With an Mutation.

机构信息

Research Triangle Institute International, Research Triangle Park, North Carolina;

Research Triangle Institute International, Research Triangle Park, North Carolina.

出版信息

Pediatrics. 2021 May;147(5). doi: 10.1542/peds.2020-011528.

Abstract

BACKGROUND

Children with gene expansions are known to experience a range of developmental challenges, including fragile X syndrome. However, little is known about early development and symptom onset, information that is critical to guide earlier identification, more accurate prognoses, and improved treatment options.

METHODS

Data from 8 unique studies that used the to assess children with an gene expansion were combined to create a data set of 1178 observations of >500 young children. Linear mixed modeling was used to explore developmental trajectories, symptom onset, and unique developmental profiles of children <5 years of age.

RESULTS

Boys with an gene full mutation showed delays in early learning, motor skills, and language development as young as 6 months of age, and both sexes with a full mutation were delayed on all developmental domains by their second birthday. Boys with a full mutation continued to gain skills over early childhood at around half the rate of their typically developing peers; girls with a full mutation showed growth at around three-quarters of the rate of their typically developing peers. Although children with a premutation were mostly typical in their developmental profiles and trajectories, mild but significant delays in fine motor skills by 18 months were detected.

CONCLUSIONS

Children with the gene full mutation demonstrate significant developmental challenges within the first 2 years of life, suggesting that earlier identification is needed to facilitate earlier implementation of interventions and therapeutics to maximize effectiveness.

摘要

背景

已知携带基因扩展的儿童会经历一系列发育挑战,包括脆性 X 综合征。然而,对于早期发育和症状出现的了解甚少,这些信息对于指导早期识别、更准确的预后和改善治疗选择至关重要。

方法

对使用基因扩展评估基因扩展儿童的 8 项独特研究的数据进行了合并,创建了一个包含超过 500 名幼儿的 1178 个观察结果的数据集。线性混合模型用于探索儿童 <5 岁时的发育轨迹、症状出现和独特的发育特征。

结果

携带基因全突变的男孩在 6 个月大时就表现出早期学习、运动技能和语言发育迟缓,而携带全突变的男女在所有发育领域的发育都在他们两岁生日时出现迟缓。携带全突变的男孩在整个幼儿期的技能增长速度大约是其正常发育同龄人的一半;携带全突变的女孩的增长速度大约是其正常发育同龄人的四分之三。尽管携带前突变的儿童在发育特征和轨迹上大多正常,但在 18 个月时发现精细运动技能有轻微但显著的延迟。

结论

携带基因全突变的儿童在生命的头 2 年就表现出明显的发育挑战,这表明需要更早地识别,以便更早地实施干预和治疗,以最大限度地提高疗效。

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