Gray P H, Jones P, O'Callaghan M J
Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia.
Dev Med Child Neurol. 2001 Sep;43(9):580-5. doi: 10.1017/s0012162201001074.
The study aimed to identify significant antenatal risk factors for cerebral palsy (CP) among extremely preterm infants with a matched case-control design. Infants born between 1989 and 1996 at 24 to 27 weeks' gestation who survived to hospital discharge were evaluated: 30 with a proven diagnosis of CP at 2 years corrected for prematurity and 120 control children matched for gestational age without CP. Information on maternal obstetric risk factors and medication was obtained. Matched analyses were performed and odds ratios (OR) and 95% confidence intervals (CI) were calculated. An antenatal diagnosis of intrauterine growth restriction was associated with an increased risk of CP (OR 6.6; 95% CI 1.8 to 25.2), while maternal administration of corticosteroids was associated with a reduced risk of CP (OR 0.4; 95% CI 0.1 to 0.98). A high rate of placental histopathology was achieved but no relation between clinical or histological chorioamnionitis or funisitis and CP was demonstrated. Maternal preeclampsia was not associated with a statistically significant reduction in the risk of CP. It is concluded that a reduced risk of CP in extremely preterm infants is associated with the antenatal use of corticosteroids.
该研究旨在通过匹配病例对照设计，确定极早早产儿中脑瘫（CP）的重要产前危险因素。对1989年至1996年期间孕24至27周出生且存活至出院的婴儿进行评估：30例在矫正胎龄2岁时确诊为CP，120例胎龄匹配的对照儿童未患CP。获取了产妇产科危险因素和用药信息。进行了匹配分析，并计算了比值比（OR）和95%置信区间（CI）。产前诊断为宫内生长受限与CP风险增加相关（OR 6.6；95% CI 1.8至25.2），而产妇使用皮质类固醇与CP风险降低相关（OR 0.4；95% CI 0.1至0.98）。胎盘组织病理学检查率较高，但未发现临床或组织学绒毛膜羊膜炎或脐带炎与CP之间存在关联。产妇子痫前期与CP风险的统计学显著降低无关。结论是，极早早产儿CP风险降低与产前使用皮质类固醇有关。
