Kok Joke H, Prick Liesbeth, Merckel Elly, Everhard Yolande, Verkerk Gijs J Q, Scherjon Sicco A
Emma Children's Hospital AMC, Department of Neonatology H3 229, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Pediatrics. 2007 Jun;119(6):e1342-50. doi: 10.1542/peds.2005-2857.
We have demonstrated earlier an accelerated maturation of the visual evoked potential in the first year of life in preterm infants with antenatal brain sparing. We have now assessed visual functioning at 11 years of age in the same cohort and compared the groups with and without brain sparing.
DESIGN/METHODS: One hundred sixteen survivors included in a study on the outcome of preterm infants born at <33 weeks' gestation with and without fetal brain sparing and admitted to the NICU were followed extensively. Ninety-eight infants (85%) were again assessed at 11 years of age. Data were available for fetal Doppler measurements indicating brain sparing, neonatal cerebral ultrasound scanning, and developmental outcome in the first 5 years. Mean birth weight was 1303 g; mean gestational age was 29.8 weeks. The infants were divided into 2 groups with and without brain sparing. Visual functioning was estimated by measuring visual acuity, visual fields, eye position, and binocular function and by visual motor tests.
Six percent of the children were found to have a visual acuity of <0.8, 12% had strabismus, and 14% to 46% showed abnormal results on the visual motor tests. No statistical differences were found between the 2 groups. However, children with severe cerebral ultrasound diagnoses in the neonatal period were found to have significantly more abnormalities on visual functioning and lower scores on visual motor tests than children without these morbidities.
Children with fetal brain sparing do not demonstrate a different development of their visual functioning at late school age. However, an abnormal cerebral ultrasound in the neonatal period is associated with impaired visual function in later life.
我们之前已经证明，产前脑保护的早产儿在出生后第一年视觉诱发电位成熟加速。我们现在评估了同一队列中11岁儿童的视觉功能，并比较了有和没有脑保护的两组儿童。
设计/方法：对116名孕周小于33周、有或没有胎儿脑保护且入住新生儿重症监护病房的早产儿进行了广泛随访，这些早产儿是一项关于其结局的研究的幸存者。98名婴儿（85%）在11岁时再次接受评估。可获得胎儿多普勒测量数据以表明脑保护情况、新生儿脑超声扫描结果以及前5年的发育结局。平均出生体重为1303克；平均孕周为29.8周。将婴儿分为有脑保护和无脑保护两组。通过测量视力、视野、眼位和双眼功能以及视觉运动测试来评估视觉功能。
发现6%的儿童视力低于0.8，12%的儿童患有斜视，14%至46%的儿童在视觉运动测试中结果异常。两组之间未发现统计学差异。然而，与没有这些疾病的儿童相比，新生儿期脑超声诊断严重的儿童在视觉功能方面有明显更多的异常，并且在视觉运动测试中的得分更低。
有胎儿脑保护的儿童在学龄后期视觉功能发育并无差异。然而，新生儿期脑超声异常与后期生活中的视觉功能受损有关。
