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评估围生期暴露于 SARS-CoV-2 的新生儿神经精神运动发育,6 月龄时使用贝利 III 量表。

Assessment of newborn neuropsychomotor development born with exposure to SARS-CoV-2 in the perinatal period using the Bayley III scale at 6 months of age.

机构信息

Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil.

Postgraduate Program in Pediatrics, Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil.

出版信息

Clinics (Sao Paulo). 2024 Aug 1;79:100460. doi: 10.1016/j.clinsp.2024.100460. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to evaluate the Neuropsychomotor Development (NPMD) of newborns exposed to SARS-CoV-2 in the perinatal period using the Bayley III scale at 6 months of age.

METHODS

Childcare appointments were scheduled for the included newborns in the study. During the 6-month consultation, the Screening Test for Bayley III Scale and, based on it, children were classified as "low risk", "moderate risk" or "high risk" in the domains: of cognitive, receptive language, expressive language, fine motor, and gross motor. Those classified as "moderate risk"; or "high risk" received guidance about NPMD stimuli and were instructed to maintain follow-up.

RESULTS

Only 13 (37.1 %) of the newborns were classified as low risk in receptive language and 18 (51.4 %) in gross motor skills, with the domains most affected. Prematurity was a risk for cognitive incompetence (moderate risk/high-risk classification) (coefficient: 1.89, Odds Ratio = 6.7, 95 % CI 1.3‒35, p = 0.02). Lower birth weight that 2.500g had a similar effect on cognitive incompetence (coefficient: 1.9, Odds Ratio = 6.2, 95 % CI 1.2‒32.2, p = 0.02). Exclusive breastfeeding at hospital discharge (n = 8) was protective for incompetence (high risk/moderate risk) in the language domain (coefficient -2.14, OR = 0.12, 95 % CI 0.02‒0.71, p = 0.02).

CONCLUSIONS

The children included in the study must be monitored and their development monitored in order to clarify whether there is a relationship between the delay in NPMD and perinatal exposure to COVID-19, as delays were observed in these preliminary results.

摘要

目的

本研究旨在通过使用贝利 III 量表在 6 个月龄时评估围产期接触 SARS-CoV-2 的新生儿的神经心理运动发育(NPMD)。

方法

为研究中的新生儿安排了儿童保健预约。在 6 个月的咨询期间,进行了贝利 III 量表筛查测试,根据该测试,儿童在认知、接受性语言、表达性语言、精细运动和粗大运动领域被分类为“低风险”、“中风险”或“高风险”。被归类为“中风险”或“高风险”的儿童接受了 NPMD 刺激指导,并被指示保持随访。

结果

只有 13 名(37.1%)新生儿在接受性语言方面被归类为低风险,18 名(51.4%)在粗大运动技能方面被归类为低风险,这些领域受影响最大。早产儿认知能力不足(中风险/高风险分类)是一种风险(早产)(系数:1.89,优势比=6.7,95%置信区间 1.3-35,p=0.02)。出生体重低于 2500g 对认知能力不足也有类似影响(系数:1.9,优势比=6.2,95%置信区间 1.2-32.2,p=0.02)。在出院时进行纯母乳喂养(n=8)对语言领域的认知能力不足(高风险/中风险)有保护作用(系数-2.14,OR=0.12,95%置信区间 0.02-0.71,p=0.02)。

结论

必须对纳入研究的儿童进行监测,并监测其发育情况,以明确 NPMD 延迟与围产期接触 COVID-19 之间是否存在关系,因为在这些初步结果中观察到了延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb72/11334819/db7fa0411226/gr1.jpg

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