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早产儿脑室周围-脑室内出血的危险因素。

Risk factors for periventricular-intraventricular hemorrhage in premature infants.

机构信息

Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2010 Mar;25(3):418-24. doi: 10.3346/jkms.2010.25.3.418. Epub 2010 Feb 17.

Abstract

Periventricular-intraventricular hemorrhage (PV-IVH) is a major cause of neurological disabilities in preterm newborns. This study aimed to determine the perinatal factors associated with PV-IVH. We conducted a retrospective case-control study from preterm infants born at < or =34 weeks of gestation and admitted to Neonatal Intensive Care Units of Seoul National University Children's Hospital and Seoul National University Bundang Hospital between June 2003 and December 2007. Neonates with no cranial sonographic data or infants transferred from other centers after three days of age were excluded. Of 1,044 eligible subjects, 59 infants with PV-IVH grade 2, 3, and 4 were allocated to the case group. The control group consisted of 118 infants without PV-IVH who were matched for gestational age and birth weight to each case of PV-IVH. At the multivariate logistic regression model, metabolic acidosis (odds ratio [OR]: 6.94; 95% confidence interval [CI]: 1.12-43.23) and use of inotropes (OR: 3.70; 95% CI: 1.16-11.84) were associated with an increased risk of PV-IVH. Maternal use of antenatal corticosteroids decreases the risk of PV-IVH (OR: 0.36; 95% CI: 0.14-0.92).

摘要

脑室周围-脑室内出血(PV-IVH)是早产儿神经功能障碍的主要原因。本研究旨在确定与 PV-IVH 相关的围产期因素。我们进行了一项回顾性病例对照研究,纳入了 2003 年 6 月至 2007 年 12 月在首尔国立大学儿童医院和首尔国立大学盆唐医院新生儿重症监护病房出生且胎龄小于或等于 34 周的早产儿。排除了无头颅超声数据或出生后 3 天内从其他中心转来的婴儿。在 1044 名符合条件的婴儿中,59 名婴儿患有 PV-IVH 2、3 和 4 级,被分配到病例组。对照组由 118 名无 PV-IVH 的婴儿组成,与每个 PV-IVH 病例的胎龄和出生体重相匹配。在多变量逻辑回归模型中,代谢性酸中毒(比值比 [OR]:6.94;95%置信区间 [CI]:1.12-43.23)和使用正性肌力药(OR:3.70;95% CI:1.16-11.84)与 PV-IVH 的风险增加相关。母亲产前使用皮质类固醇可降低 PV-IVH 的风险(OR:0.36;95% CI:0.14-0.92)。

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