目的 研究人类免疫缺陷病毒（human immunodeficiency virus，HIV）暴露未感染（HIV-exposed uninfected，HEU）婴幼儿神经心理发育水平，探讨母亲HIV感染对HEU婴幼儿神经心理发育的影响。 方法 选取2019年6月至2020年12月在云南省4家妇幼保健院专案管理且符合纳入标准的141名0~18月龄HIV感染母亲所生未感染HIV，即HEU婴幼儿作为HEU组，以性别、年龄、出生方式、出生体重、胎龄为配对条件，按1∶1配对141名健康母亲所生婴幼儿，即无HIV暴露、无HIV感染（HIV-unexposed uninfected，HUU）婴幼儿为对照，应用Griffiths发育评估量表中文版（Griffiths Development Scales-Chinese Edition，GDS-C）评估运动、个人-社会、听力语言、手眼协调、表现（视感知空间整合能力）5个领域发育情况，同时采用问卷调查方式收集有关信息。采用多因素logistic回归分析探讨母亲HIV感染对HEU婴幼儿神经心理发育的影响。 结果 HEU组听力语言和表现2个领域迟缓检出率显著高于HUU组（P<0.05）。多因素logistic回归分析显示，HIV暴露增加了婴幼儿听力语言（OR=2.661，95%CI：1.171~6.047）和表现（OR=2.321，95%CI：1.156~4.658）2个领域迟缓发生的风险（P<0.05）。 结论 母亲感染HIV可对其分娩的未感染HIV婴幼儿听力语言和表现领域的发育产生负面影响，其机制有待进一步研究。 ［中国当代儿科杂志，2022，24（9）：967-972］
Abstract
Objective To investigate the level of neuropsychological development in human immunodeficiency virus (HIV)-exposed uninfected (HEU) infants/young children and the influence of maternal HIV infection on the neuropsychological development of HEU infants/young children. Methods A total of 141 HEU infants/young children, aged 0-18 months and born to HIV-infected mothers, who were managed in four maternal and child health care hospitals in Yunnan Province of China from June 2019 to December 2020 and met the inclusion criteria were enrolled as the HEU group. A total of 141 HIV-unexposed uninfected (HUU) infants/young children who were born to healthy mothers and managed in the same hospitals, matched at a ratio of 1:1 based on sex, age, method of birth, birth weight, and gestational age, were enrolled as controls. Griffiths Development Scales-Chinese Edition was used to assess the development in the five domains of locomotion, personal-social, hearing and language, eye-hand co-ordination, and performance (visual perception and space integration ability). A questionnaire survey was performed to collect relevant information. The multivariate logistic regression analysis was used to assess the influence of maternal HIV infection on the neuropsychological development of HEU infants/young children. Results Compared with the HUU group, the HEU group had significantly higher detection rates of retardation in the domains of hearing and language and performance (P<0.05). The multivariate logistic regression analysis showed that maternal HIV infection increased the risk of retardation in the domains of hearing and language (OR=2.661, 95%CI: 1.171-6.047, P<0.05) and performance (OR=2.321, 95%CI: 1.156-4.658, P<0.05). Conclusions Maternal HIV infection can negatively affect the development of hearing and language and performance in HEU infants/young children, and further studies are needed to clarify related mechanisms. Citation:Chinese Journal of Contemporary Pediatrics, 2022, 24(9): 967-972
关键词
人类免疫缺陷病毒暴露 /
神经心理发育 /
儿童
Key words
Human immunodeficiency virus-exposure /
Neuropsychological development /
Child
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基金
国家“十三五”科技重大专项（2018ZX10715006-004）。
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