Cumulative Febrile, Respiratory, and Gastrointestinal Illness Among Infants in Rural Guatemala and Association With Neurodevelopmental and Growth Outcomes.
Cumulative Febrile, Respiratory, and Gastrointestinal Illness Among Infants in Rural Guatemala and Association With Neurodevelopmental and Growth Outcomes.
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危地马拉农村地区婴儿的累积发热、呼吸系统和胃肠道疾病及其与神经发育和生长结果的关系。
DOI：
10.1097/inf.0000000000004006
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Natrajan,
中科院分区：
文献类型：
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作者：
Olson,Daniel;Lamb,MollyM;Connery,AmyK;Colbert,AlisonM;Calvimontes,DivaM;Bauer,Desiree;Paniagua-Avila,MAlejandra;Martínez,MaríaAlejandra;Arroyave,Paola;Hernandez,Sara;Colborn,KathrynL;Roell,Yannik;Waggoner,JesseJ;Natrajan,
背景：生命早期的传染病暴露越来越被认为是随后生长和神经发育不良的危险因素。我们的目的是评估危地马拉婴儿出生队列中累积疾病与神经发育和生长结局之间的相关性：方法：从2017年6月至2018年7月，在危地马拉西南部农村资源有限地区生活的0-3个月大的婴儿入选，每周进行一次家庭监测，以监测婴儿报告的咳嗽、发热和呕吐/腹泻。他们还进行了人体测量评估和神经发育测试与马伦量表的早期学习（MSEL）在登记，6个月，和1 year.Results：499名登记的婴儿，430（86.2%）完成了所有的研究程序，并被列入分析。在12-15个月时，140名（32.6%）婴儿发育迟缓（年龄别身高Z [LAZ]评分<-2 SD），72名（16.7%）婴儿患有小头畸形（枕额围[OFC]<-2 SD）。在多变量分析中，报告咳嗽疾病的累积病例越多，（β =-0.08/患病周，P= 0.06）和发热性疾病（β =-0.36/患病周，P< 0.001）分别与12-15个月时较低的MSEL早期学习综合（ELC）评分轻微或显著相关;与任何疾病（咳嗽、发热和/或呕吐/腹泻; P= 0.27）或与单独的腹泻/呕吐疾病的累积病例无关（P= 0.66）。累积的疾病和发育迟缓或小头畸形在12-15 months.Conclusions：这些研究结果突出了负面的累积后果频繁发热和呼吸系统疾病在婴儿期的神经发育之间的关联。未来的研究应该探索病原体特异性疾病，与这些综合征性疾病相关的宿主反应，以及它们与神经发育的关系。
Background:Infectious disease exposures in early life are increasingly recognized as a risk factor for poor subsequent growth and neurodevelopment. We aimed to evaluate the association between cumulative illness with neurodevelopment and growth outcomes in a birth cohort of Guatemalan infants.Methods:From June 2017 to July 2018, infants 0–3 months of age living in a resource-limited region of rural southwest Guatemala were enrolled and underwent weekly at-home surveillance for caregiver-reported cough, fever, and vomiting/diarrhea. They also underwent anthropometric assessments and neurodevelopmental testing with the Mullen Scales of Early Learning (MSEL) at enrollment, 6 months, and 1 year.Results:Of 499 enrolled infants, 430 (86.2%) completed all study procedures and were included in the analysis. At 12–15 months of age, 140 (32.6%) infants had stunting (length-for-age Z [LAZ] score<–2 SD) and 72 (16.7%) had microcephaly (occipital-frontal circumference [OFC]<–2 SD). In multivariable analysis, greater cumulative instances of reported cough illness (beta=–0.08/illness-week, P= 0.06) and febrile illness (beta=–0.36/illness-week, P< 0.001) were marginally or significantly associated with lower MSEL Early Learning Composite (ELC) Score at 12–15 months, respectively; there was no association with any illness (cough, fever, and/or vomiting/diarrhea; P= 0.27) or with cumulative instances of diarrheal/vomiting illness alone (P= 0.66). No association was shown between cumulative instances of illness and stunting or microcephaly at 12–15 months.Conclusions:These findings highlight the negative cumulative consequences of frequent febrile and respiratory illness on neurodevelopment during infancy. Future studies should explore pathogen-specific illnesses, host response associated with these syndromic illnesses, and their association with neurodevelopment.