van Hinsbergh Ted, Elbers Roy-G, Bouman Zita, van Furth Marceline, Obihara Charlie
Department of Pediatrics, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, Tilburg, 5022 LC, The Netherlands.
Amsterdam UMC, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty (AMC), University of Amsterdam, Amsterdam, The Netherlands.
Eur J Pediatr. 2022 May;181(5):2005-2016. doi: 10.1007/s00431-022-04402-1. Epub 2022 Feb 4.
Though parechovirus (PeV) and enterovirus (EV) are common causes of central nervous system (CNS) infection in childhood, little is known about their long-term neurologic/neurodevelopmental complications. We investigated, longitudinally over a 5-year period, motor neurodevelopment in term-born newborns and infants with RT-qPCR-confirmed PeV- or EV-CNS infection. Motor neurodevelopment was assessed with standardized tests: Alberta Infant Motor Scale (AIMS), Bayley Scales of Infant and Toddler Development version-3 (Bayley-3-NL), and Movement Assessment Battery for Children version-2 (M-ABC-2-NL) at 6, 12, 24, and 60 months post-infection. Results of children with PeV-CNS infection were compared with those of peers with EV-CNS infection and with Dutch norm references. In the multivariate analyses adjustments were made for age at onset, gender, maternal education, and time from CNS infection Sixty of 172 eligible children aged ≤ 3 months were included. Children with PeV-CNS infection had consistently lower, non-significant mean gross motor function (GMF) Z-scores, compared with peers with EV-CNS infection and population norm-referenced GMF. Their GMF improved between 6 and 24 months and decreased at 5 years. Their fine motor function (FMF) scores fell within the population norm reference.
These results suggest that the impact of PeV-A3-CNS infection on gross motor neurodevelopment in young children might manifest later in life. They highlight the importance of longitudinal neurodevelopmental assessments of children with PeV-A3-CNS infection up to school age.
• Human parechovirus (PeV) is a major cause of central nervous system infection (CNS infection) in newborns and infants. • There is interest in the neurological and neurodevelopmental outcome of newborns and infants with PeV-A3-CNS infection.
• This prospective study compares the motor neurodevelopment of term-born newborns and infants with PeV-A3-CNS infection with those with EV-CNS infection and with norm references. • The results support the importance of follow-up of newborns and infants with PeV-A3-CNS infection to detect subtle neurodevelopmental delay and start early interventions.
虽然微小病毒（PeV）和肠道病毒（EV）是儿童中枢神经系统（CNS）感染的常见病因，但对其长期神经/神经发育并发症知之甚少。我们对经逆转录定量聚合酶链反应（RT-qPCR）确诊为PeV或EV-CNS感染的足月儿和婴儿的运动神经发育进行了为期5年的纵向研究。在感染后6、12、24和60个月，使用标准化测试评估运动神经发育：艾伯塔婴儿运动量表（AIMS）、贝利婴幼儿发展量表第3版（Bayley-3-NL）和儿童运动评估量表第2版（M-ABC-2-NL）。将PeV-CNS感染儿童的结果与EV-CNS感染儿童的结果以及荷兰正常参考值进行比较。在多变量分析中，对发病年龄、性别、母亲教育程度和距CNS感染的时间进行了调整。纳入了172名年龄≤3个月的符合条件儿童中的60名。与EV-CNS感染儿童和总体正常参考的GMF相比，PeV-CNS感染儿童的平均粗大运动功能（GMF）Z评分一直较低，但无统计学意义。他们的GMF在6至24个月之间有所改善，在5岁时下降。他们的精细运动功能（FMF）评分在总体正常参考范围内。
这些结果表明，PeV-A3-CNS感染对幼儿粗大运动神经发育的影响可能在以后的生活中显现出来。它们突出了对PeV-A3-CNS感染儿童进行长达学龄期的纵向神经发育评估的重要性。
• 人微小病毒（PeV）是新生儿和婴儿中枢神经系统感染（CNS感染）的主要原因。• 人们对患有PeV-A3-CNS感染的新生儿和婴儿的神经和神经发育结局感兴趣。
• 这项前瞻性研究比较了患有PeV-A3-CNS感染的足月儿和婴儿与患有EV-CNS感染的婴儿以及正常参考值的运动神经发育情况。• 结果支持对患有PeV-A3-CNS感染的新生儿和婴儿进行随访以检测细微的神经发育延迟并尽早开始干预的重要性。
