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因母亲先兆子痫在妊娠32周前分娩:新生儿结局及2岁时的发育结局。

Delivery before 32 weeks of gestation for maternal pre-eclampsia: neonatal outcome and 2-year developmental outcome.

作者信息

Cheng Shao-Wen, Chou Hung-Chieh, Tsou Kuo-Inn, Fang Li-Jung, Tsao Po-Nien

机构信息

Department of Pediatrics, Taipei Municipal Women and Children's Hospital, Taiwan.

出版信息

Early Hum Dev. 2004 Jan;76(1):39-46. doi: 10.1016/j.earlhumdev.2003.10.004.

Abstract

BACKGROUND AND OBJECTIVE

In the literature, there are conflicting data on the neonatal outcome in preterm infants who were delivered for maternal pre-eclampsia. The purpose of this study is to investigate the effect of maternal pre-eclampsia on neonatal morbidity and 2-year developmental outcome in a population of preterm infants delivered before 32 weeks of gestation.

METHODS

The hospital records of all 89 surviving VLBW infants with GA below 32 weeks born from January 1997 to December 1999 were reviewed retrospectively. Data on respiratory outcome, sepsis and intraventricular hemorrhage (IVH) were compiled and analyzed for their association to maternal pre-eclampsia. Seventy-eight infants were assessed employing the Bayley Scales of Infant Development for developmental outcome at 2 years of corrected age.

RESULTS

There was no difference in neonatal morbidity between groups. More infants born to pre-eclamptic mothers had lower MDI scores at 24 months of age (P=0.04) as compared to infants without maternal pre-eclampsia. After multiple logistic regression analysis, pre-eclampsia (P=0.007, OR=10.8) remained a significant risk factor of mildly delayed MDI at 24 months of age.

CONCLUSION

Delivery before 32 weeks because of pre-eclampsia was associated with an increased risk of poor cognitive outcome. There was no significant difference in the postnatal course in comparison with infants born after pregnancies not complicated by pre-eclampsia.

摘要

背景与目的

在文献中,关于因母亲先兆子痫而早产的新生儿结局存在相互矛盾的数据。本研究的目的是调查母亲先兆子痫对妊娠32周前出生的早产儿群体的新生儿发病率和2岁发育结局的影响。

方法

回顾性分析了1997年1月至1999年12月出生的所有89例存活的胎龄小于32周的极低出生体重儿的医院记录。收集并分析了呼吸结局、败血症和脑室内出血(IVH)的数据,以探讨其与母亲先兆子痫的关联。78例婴儿在矫正年龄2岁时采用贝利婴儿发育量表进行发育结局评估。

结果

两组之间的新生儿发病率没有差异。与母亲无先兆子痫的婴儿相比,先兆子痫母亲所生的更多婴儿在24个月时的智力发育指数(MDI)得分较低(P = 0.04)。经过多因素逻辑回归分析,先兆子痫(P = 0.007,比值比[OR]=10.8)仍然是24个月时MDI轻度延迟的一个显著危险因素。

结论

因先兆子痫在32周前分娩与认知结局不良风险增加有关。与非先兆子痫妊娠后出生的婴儿相比,产后病程没有显著差异。

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