Nesterenko Tetyana H, Nolan Brian, Hammad Tarek A, Aly Hany
Department of Neonatology, Children's National Medical Center, Washington, DC, USA.
Am J Perinatol. 2008 Apr;25(4):251-4. doi: 10.1055/s-2008-1075038.
Infants with bronchopulmonary dysplasia (BPD) are known to have developmental delays, but a direct link between oxygen (O (2)) exposure and brain growth has not been explored. Our objective was to test the hypothesis that the use of O (2) is associated with delays in head growth (DHG) in premature infants with BPD. We conducted a retrospective study on a cohort of infants with BPD (birthweight [BW] < 1500 g, gestational age < 34 weeks). The study population was divided into two groups based on their head circumference (HC) measured at birth. Group 1 represented infants with birth HC > or = 50% for their age on growth chart, and Group 2 represented infants with birth HC < 50% for their age. We recorded HC at hospital discharge and at 6 months of age; and the amount of DHG was calculated (DHG = current age in weeks - the age that matches the 50th percentile for current HC). Regression analysis was conducted to determine the relationship between the duration of O (2) use and DHG in both groups, controlling for BW, discharge weight, gender, and duration of mechanical ventilation (MV). Data were expressed in mean +/- standard error of mean. A total of 137 sequential infants with BPD were studied; of them 65 infants were included in group 1 and 72 infants were included in group 2. The 2 groups did not differ in GA, gender total O (2) days, and total days on MV. At hospital discharge there was no difference between groups in terms of DHG (78% versus 83%, respectively). At 6 months of age, there were more infants in group 2 who had DHG (44% versus 67%, respectively; P < 0.01). In group 1, the amount of DHG correlated only with BW ( P = 0.05). It did not correlate with discharge weight, gender, duration of O (2) use, or duration of MV. In group 2, the amount of DHG correlated only with the duration of O (2) use ( P = 0.04) It did not correlate with BW, discharge weight, gender, or duration of MV. Each 10 days of O (2) use in group 2 was associated with 1.5 +/- 0.1 days of DHG. We concluded that duration of O (2) use is associated with a delay in head growth in infants born with HC < 50th percentile. This study does not clarify whether the use of O (2) is a marker of severity of illness or a contributing factor to DHG in infants with BPD. The mechanisms for this relation require further exploration.
已知患有支气管肺发育不良（BPD）的婴儿存在发育迟缓的情况，但氧气（O₂）暴露与脑生长之间的直接联系尚未得到探究。我们的目的是检验这一假设：对于患有BPD的早产儿，使用O₂与头围生长延迟（DHG）有关。我们对一组患有BPD的婴儿（出生体重[BW]<1500g，胎龄<34周）进行了一项回顾性研究。根据出生时测量的头围（HC）将研究人群分为两组。第1组代表出生时HC在生长图表上大于或等于其年龄对应值50%的婴儿，第2组代表出生时HC小于其年龄对应值50%的婴儿。我们记录了出院时和6个月大时的HC；并计算了DHG的量（DHG = 当前周龄 - 与当前HC第50百分位数匹配的年龄）。进行回归分析以确定两组中O₂使用时长与DHG之间的关系，同时控制BW、出院体重、性别和机械通气（MV）时长。数据以均值±均值标准误差表示。总共研究了137例连续的患有BPD的婴儿；其中65例婴儿纳入第1组，72例婴儿纳入第2组。两组在胎龄、性别、总O₂天数和MV总天数方面无差异。出院时，两组在DHG方面无差异（分别为78%和83%）。在6个月大时，第2组中存在DHG的婴儿更多（分别为44%和67%；P<0.01）。在第1组中，DHG的量仅与BW相关（P = 0.05）。它与出院体重、性别、O₂使用时长或MV时长均无关联。在第2组中，DHG的量仅与O₂使用时长相关（P = 0.04）。它与BW、出院体重、性别或MV时长均无关联。第2组中每使用10天O₂与1.5±0.1天的DHG相关。我们得出结论，对于出生时HC低于第50百分位数的婴儿，O₂使用时长与头围生长延迟有关。本研究并未阐明O₂的使用是疾病严重程度的标志物还是患有BPD的婴儿DHG的一个促成因素。这种关系的机制需要进一步探究。
