Pediatric Neurology Department, Iashvili Children's Central Hospital, 0159 Tbilisi, Georgia.
Eur J Paediatr Neurol. 2010 May;14(3):247-52. doi: 10.1016/j.ejpn.2009.07.004. Epub 2009 Aug 15.
Three hundred-forty-eight out of a regional population of 1272 newborn infants were randomly chosen and followed neurologically until age of two years to study the epidemiology of neurodevelopmental disorders, and to reveal the main factors influencing outcome. The most frequent neonatal pathologies were low Apgar scores - 45 (3.5%), neonatal sepsis - 28 (2.2%), neonatal seizures - 26 (2.0%), neonatal sepsis complicated with bacterial meningitis - 13 (1.0%), traumatic injury of peripheral nerves - 7 (0.6%), intracranial hemorrhages - 4 (0.3%) and CNS malformations - 3 (0.2%). At the age of 24 months abnormal development was identified in 29 cases (8.5%) of children, comprising global developmental delay in five (1.5%), unclassified motor problems (hypotonia without ataxia) in four (1.2%), cerebral palsy in three (0.9%), behavioral/sleep disorders in 12 (3.5%) and epilepsy in five (1.5%). The most significant single risk factors for abnormal neurodevelopmental outcome were maternal age, chorioamnionitis, gestational age <37 weeks, pathological delivery, and a low (<5) Apgar score at 5min after birth. Coexistence of several risk factors increased the probability of an adverse outcome.
从一个 1272 名新生儿的地区人群中随机选择了 348 名，并对其进行了神经学随访，直到 2 岁，以研究神经发育障碍的流行病学，并揭示影响结果的主要因素。最常见的新生儿病理包括低 Apgar 评分-45 例（3.5%）、新生儿败血症-28 例（2.2%）、新生儿癫痫发作-26 例（2.0%）、新生儿败血症合并细菌性脑膜炎-13 例（1.0%）、周围神经创伤性损伤-7 例（0.6%）、颅内出血-4 例（0.3%）和中枢神经系统畸形-3 例（0.2%）。在 24 个月时，29 例（8.5%）儿童被发现存在发育异常，包括 5 例（1.5%）全面发育迟缓、4 例（1.2%）未分类运动问题（无共济失调的低张力）、3 例（0.9%）脑瘫、12 例（3.5%）行为/睡眠障碍和 5 例（1.5%）癫痫。导致神经发育不良结局的最显著单一风险因素是母亲年龄、绒毛膜羊膜炎、妊娠年龄<37 周、病理性分娩和出生后 5 分钟 Apgar 评分<5。多种风险因素的共存增加了不良结果的可能性。
