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HIV 暴露但未感染儿童与 HIV 未暴露未感染儿童在幼儿期的神经发育比较。

Neurodevelopment of HIV-exposed uninfected children compared with HIV-unexposed uninfected children during early childhood.

机构信息

Department of Psychology, The Hospital for Sick Children.

Division of Infectious Diseases, The Hospital for Sick Children.

出版信息

Dev Psychol. 2022 Mar;58(3):551-559. doi: 10.1037/dev0001319.

Abstract

HIV-exposed uninfected (HEU) children during the preschool and early school ages may be at-risk for neurodevelopmental challenges due to in utero and perinatal exposure to HIV and/or antiretroviral (ARV) medications. HEU children and HIV-unexposed uninfected (HUU) children from the community were recruited and tested at 3 to 4 and 5 to 6 years of age. Demographic information, HIV/ARV exposure and measures of intelligence, visuomotor skills, and adaptive functioning were obtained. Nonparametric tests assessed group differences and multiple regression analyses adjusted for demographic variables. Additional multiple regression analyses were performed within the HEU group to investigate associations between neurodevelopmental measures and variables of HIV/ARV exposure. At 3 to 4 years, 211 HEU children and 31 HUU children were assessed, and 144 HEU children and 58 HUU children were assessed at 5 to 6 years of age. At 3 to 4 years of age, HEU children scored significantly lower on measures of Full-Scale IQ, Performance IQ, visual motor integration, and adaptive functioning. At 5 to 6 years of age, HEU children scored significantly lower on all neurodevelopmental measures. At both ages, children who were female and those with mothers who were employed achieved higher scores on measures intellectual ability and/or adaptive functioning. Within the HEU group, no consistent associations were found between neurodevelopmental measures and HIV/ARV specific variables. HEU children demonstrated significantly lower scores on neurodevelopmental measures than HUU children during early childhood. Gaps in verbal intellectual abilities were identified with age, highlighting the importance of monitoring neurodevelopment in this population over time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

HIV 暴露未感染 (HEU) 的儿童在学龄前和小学年龄可能面临神经发育挑战的风险,这是由于宫内和围产期暴露于 HIV 和/或抗逆转录病毒 (ARV) 药物。招募了社区中的 HEU 儿童和 HIV 未暴露未感染 (HUU) 儿童,并在 3 至 4 岁和 5 至 6 岁时进行了测试。获取了人口统计学信息、HIV/ARV 暴露情况以及智力、视动技能和适应功能的测量结果。非参数检验评估了组间差异,并对人口统计学变量进行了多元回归分析。在 HEU 组内进行了额外的多元回归分析,以调查神经发育测量结果与 HIV/ARV 暴露变量之间的关联。在 3 至 4 岁时,评估了 211 名 HEU 儿童和 31 名 HUU 儿童,在 5 至 6 岁时,评估了 144 名 HEU 儿童和 58 名 HUU 儿童。在 3 至 4 岁时,HEU 儿童在全量表智商、表现智商、视觉运动整合和适应功能方面的得分明显较低。在 5 至 6 岁时,HEU 儿童在所有神经发育测量结果上的得分均明显较低。在这两个年龄组中,女性儿童和母亲有工作的儿童在智力能力和/或适应功能方面的得分较高。在 HEU 组内,未发现神经发育测量结果与 HIV/ARV 特定变量之间存在一致的关联。与 HUU 儿童相比,HEU 儿童在幼儿期的神经发育测量结果明显较低。随着年龄的增长,发现言语智力能力存在差距,这强调了随着时间的推移监测该人群神经发育的重要性。(PsycInfo 数据库记录 (c) 2022 APA,保留所有权利)。

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