Ancel P-Y
Inserm U149, Unité de Recherches Epidémiologiques en Santé Périnatale et Santé des Femmes, 123, boulevard de Port-Royal, 75014 Paris, France.
J Gynecol Obstet Biol Reprod (Paris). 2004 Oct;33(6 Pt 1):461-74. doi: 10.1016/s0368-2315(04)96559-3.
Advances in perinatal care have resulted in a sharply increasing survival rate among very preterm infants. However, there is some concern about the later neurodevelopmental outcome of those infants who survive. In this paper, we review the prevalence estimates of motor (cerebral palsy), sensorineural and cognitive impairments and their recent time-trends in very preterm infants.
A review of studies describing neurodevelopmental outcome of very preterm infants in Europe, Australia and America North.
The gestational age-specific prevalences of cerebral palsy (CP) were 72-86 for extremely preterm children (<28 weeks), 32-60 for very preterm (28-31 weeks) and 5-6 for moderate preterm (32-36 weeks), and 1.3-1.5 for term children per 1000. The live birth prevalence for CP remained unchanged in extremely and very preterm infants since 1990. The prevalence estimates of moderate and severe cognitive impairments are 15 to 25% in very preterm children. Less than 4% of very preterm infants develop severe hearing or visual loss.
This review indicates that very preterm infants have high risk of disability. Most studies have been conducted between 1985 and 1995. Thus, these results should be interpreted with caution before generalisation to recent cohorts.
围产期护理的进展使得极早产儿的存活率急剧上升。然而,对于那些存活下来的婴儿的后期神经发育结局存在一些担忧。在本文中,我们回顾了极早产儿运动(脑瘫)、感觉神经和认知障碍的患病率估计及其近期的时间趋势。
对描述欧洲、澳大利亚和北美极早产儿神经发育结局的研究进行综述。
极早产儿(<28周)脑瘫(CP)的孕周特异性患病率为每1000例中有72 - 86例,极早产儿(28 - 31周)为32 - 60例,中度早产儿(32 - 36周)为5 - 6例。足月儿为1.3 - 1.5例。自1990年以来,极早产儿和极早产儿中CP的活产患病率保持不变。极早产儿中中度和重度认知障碍的患病率估计为15%至25%。不到4%的极早产儿会出现严重听力或视力丧失。
本综述表明极早产儿有很高的残疾风险。大多数研究是在1985年至1995年之间进行的。因此,在推广到最近的队列之前,应谨慎解释这些结果。