High prevalence of developmental concern amongst infants at 12 months following hospitalised parechovirus infection

Philip N Britton; Gulam Khandaker; Ameneh Khatami; Suzy Teutsch; Stephanie Francis; Brendan J McMullan; Cheryl A Jones

doi:10.1111/jpc.13728

High prevalence of developmental concern amongst infants at 12 months following hospitalised parechovirus infection

J Paediatr Child Health. 2018 Mar;54(3):289-295. doi: 10.1111/jpc.13728. Epub 2017 Sep 28.

Authors

Philip N Britton^{1

2}, Gulam Khandaker¹, Ameneh Khatami², Suzy Teutsch¹, Stephanie Francis³, Brendan J McMullan³, Cheryl A Jones^{1

2}

Affiliations

¹ Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, New South Wales, Australia.
² Department of Infectious Diseases and Microbiology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
³ Department of Infectious Diseases and Immunology, Sydney Children's Hospital, Sydney, New South Wales, Australia.

PMID: 28960646
DOI: 10.1111/jpc.13728

Abstract

Aim: The human parechovirus (HPeV) is an increasingly recognised cause of sepsis and central nervous system infection in young infants for which there are limited long-term outcome data. We aimed to assess neurodevelopmental outcome and quality of life in infants following hospitalised HPeV infection.

Methods: This cohort study was a 12-month follow-up of infants who were hospitalised with confirmed HPeV infection at the Sydney Children's Hospitals Network during an outbreak in Sydney in 2013. Telephone interviews were conducted with parents/guardians. We administered standardised questionnaires, including: Ages and Stages Questionnaire (ASQ), Liverpool Outcome Score-follow-up, Pediatric Quality of Life Inventory(PedsQL) Infant scales and Short-Form health survey (SF-12).

Results: We followed up 46 of 79 infants (58%) aged between 12 and 16 months who had been hospitalised with HPeV infection; 19% showed significant concern in developmental attainment (ASQ3 score <2 standard deviation below population mean), and 50% showed some concern (<1 standard deviation below mean). ASQ3 developmental outcome was associated with the presence of neurodevelopmental sequelae (lower total Liverpool Outcome Score) and poorer health-related quality of life (HRQOL) in physical functioning (PedsQL physical component score), but not overall HRQOL (total PedsQL score) or parental HRQOL (SF-12 scores). No significant associations were identified between clinical or laboratory features during acute hospitalisation and adverse outcome on ASQ3.

Conclusions: A high proportion of infants show developmental concern at 12-month follow-up post-hospitalisation with HPeV infection. Clinical features during hospitalisation were not associated with adverse outcomes at 12 months. These results suggest that careful follow-up of young infants hospitalised with HPeV disease may be warranted.

Keywords: central nervous system; development; infant; newborn; outcome; parechovirus.

MeSH terms

Analysis of Variance
Cohort Studies
Developmental Disabilities / epidemiology
Developmental Disabilities / etiology*
Disease Outbreaks
Female
Follow-Up Studies
Health Status
Hospitalization
Humans
Infant
Infant, Newborn
Infant, Newborn, Diseases / epidemiology
Male
Motor Disorders / epidemiology
Motor Disorders / etiology*
New South Wales / epidemiology
Parechovirus*
Picornaviridae Infections / complications*
Picornaviridae Infections / epidemiology
Prevalence
Quality of Life