Cheung P Y, Barrington K J, Finer N N, Robertson C M
Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
Pediatr Pulmonol. 1999 Jan;27(1):14-20. doi: 10.1002/(sici)1099-0496(199901)27:1<14::aid-ppul4>3.0.co;2-0.
Apnea commonly occurs in preterm infants and may persist beyond term. We prospectively investigated the relationship between apnea that persisted beyond 35 weeks post-conceptional age and subsequent neurodevelopment in early childhood. Between January, 1990-November, 1993, we performed predischarge respiratory recordings, using 24-hr, 4-channel pneumography, at 35 weeks or more of postconceptional age in 164 infants (birth weight, <1,250 g; gestational age, < or = 32 weeks), who subsequently underwent multidisciplinary neurodevelopmental assessment at 15-64 (median 24) months of adjusted age. The duration of initial artificial ventilation for respiratory distress syndrome and the grade of intraventricular hemorrhage were independent predictors of neurodevelopmental outcome. Mean oximetry desaturation and frequency of predischarge apnea correlated with mental and motor developmental scores. Mean oximetry desaturation during apnea was an independent predictor for motor score in the total population, and for both mental and motor scores in 50 infants with grade 3 or 4 intraventricular hemorrhage, but not in 114 infants without grade 3 or 4 intraventricular hemorrhage. Despite its limited predictability for early childhood neurodevelopment, predischarge respiratory recordings may be useful in predicting subsequent neurodevelopment of high-risk preterm infants, especially those with severe intraventricular hemorrhage.
呼吸暂停常见于早产儿，且可能持续至足月后。我们前瞻性地研究了孕龄35周后仍持续存在的呼吸暂停与幼儿期随后神经发育之间的关系。在1990年1月至1993年11月期间，我们在164例婴儿（出生体重<1250g；胎龄≤32周）孕龄35周或更大时进行出院前呼吸记录，采用24小时4通道呼吸描记法，这些婴儿随后在矫正年龄15 - 64（中位数24）个月时接受了多学科神经发育评估。呼吸窘迫综合征初始人工通气的持续时间和脑室内出血的分级是神经发育结局的独立预测因素。出院前平均血氧饱和度下降程度和呼吸暂停频率与智力和运动发育评分相关。呼吸暂停期间的平均血氧饱和度下降程度是总体人群运动评分的独立预测因素，在50例3级或4级脑室内出血婴儿中是智力和运动评分的独立预测因素，但在114例无3级或4级脑室内出血的婴儿中不是。尽管出院前呼吸记录对幼儿神经发育的预测性有限，但它可能有助于预测高危早产儿尤其是有严重脑室内出血的早产儿随后的神经发育情况。
