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先天性寨卡综合征患儿在 12 和 24 个月时的神经发育结局。

Neurodevelopmental outcomes in a cohort of children with congenital Zika syndrome at 12 and 24 months of age.

机构信息

SARAH Network of Rehabilitation Hospitals, Rio de Janeiro, Brazil.

Federal Fluminense University, Niterói, Brazil.

出版信息

Child Care Health Dev. 2023 Mar;49(2):304-310. doi: 10.1111/cch.13044. Epub 2022 Aug 18.

Abstract

BACKGROUND

Early child development is a critical stage of life that influences social, educational and health outcomes worldwide. A few years after Zika epidemic, families of children born with congenital Zika syndrome (CZS) continue to face uncertainties when it comes to the development of their children. The present study sought to analyse the developmental trajectories of a subset of children born with CZS in the first 24 months of life.

METHODS

Thirty-five children with CZS were assessed with the Bayley-III Scales at 12 and 24 months of age from November 2016 to December 2018 in a rehabilitation centre in Brazil. Inclusion criteria included children with established diagnosis of CZS. Exclusion criteria included the presence of arthrogryposis, prematurity, irregular follow-up, clinical complications or other causes of microcephaly. Children born with CZS who evolved with cerebral palsy (CP) were classified according to the Gross Motor Function Classification System (GMFCS) at 2 years of age.

RESULTS

At 12 months of age mean composite scores on the Bayley cognitive, communication and motor scores were 57.71 (SD 7.11), 57.94 (SD 14.34) and 49.26 (7.20), respectively. At 24 months of age, composite scores were 57.43 (SD 7.11), 53.60 (SD 12.29) and 48.83 (7.76). In addition, 31 (88.57%) out of 34 children diagnosed with CP were classified as GMFCS levels IV and V.

CONCLUSION

Zika virus congenital infection is a risk factor for functional impairments across all developmental domains having a direct and substantial negative impact in early child development.

摘要

背景

儿童早期发展是生命的关键阶段,影响着全球的社会、教育和健康结果。在寨卡疫情发生几年后,先天性寨卡综合征(CZS)患儿的家庭在其子女的发育问题上仍面临诸多不确定性。本研究旨在分析 24 月龄内患有 CZS 的儿童的发育轨迹。

方法

2016 年 11 月至 2018 年 12 月,巴西一家康复中心对 35 名患有 CZS 的儿童进行了贝利 III 量表评估,评估年龄为 12 月龄和 24 月龄。纳入标准包括已确诊为 CZS 的儿童。排除标准包括存在关节挛缩、早产、随访不规律、临床并发症或其他原因导致的小头畸形。2 岁时根据粗大运动功能分类系统(GMFCS)对患有脑瘫(CP)的 CZS 患儿进行分类。

结果

12 月龄时,贝利认知、沟通和运动评分的平均综合评分为 57.71(SD 7.11)、57.94(SD 14.34)和 49.26(7.20)。24 月龄时,综合评分为 57.43(SD 7.11)、53.60(SD 12.29)和 48.83(7.76)。此外,34 名被诊断为 CP 的儿童中有 31 名(88.57%)被归类为 GMFCS 水平 IV 和 V。

结论

寨卡病毒先天性感染是所有发育领域功能障碍的危险因素,对儿童早期发育有直接且显著的负面影响。

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