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极低出生体重儿铁状态与神经发育结局之间的关联。

Association between iron status and neurodevelopmental outcomes among VLBW infants.

作者信息

Kon Noriko, Tanaka Kyoko, Sekigawa Mariko, Negishi Yoshie, Yoshikawa Naomi, Hisata Ken, Shoji Hiromichi, Shimizu Toshiaki

机构信息

Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Brain Dev. 2010 Nov;32(10):849-54. doi: 10.1016/j.braindev.2009.12.003. Epub 2010 Apr 24.

Abstract

OBJECTIVE

Our purpose was to evaluate iron status and neurodevelopmental outcomes in infants with and without extrauterine growth restriction (EUGR).

METHODS

This observational study evaluated 38 medically stable premature infants, with birth weights below 1500g. Iron status was determined by measuring venous levels of Hb, Fe, and serum ferritin. The infants were divided into EUGR and non-EUGR groups. At a corrected age of 18months, neurodevelopmental outcomes were checked using the Bayley scales, and body weight, body length, and head circumference were measured.

RESULTS

Hb levels at corrected ages of 1 and 3months and iron at a corrected age of 1 and 9months were significantly lower in the EUGR group compared with those of the non-EUGR group. There was no significant difference in the MDI score between the groups, but the PDI score at a corrected age of 18months was significantly lower in the EUGR group. We found a positive correlation between the serum level of Fe at 1month of age and PDI score at 18months of age. Head circumference at a corrected age of 18months did not differ between two groups, although body weight and length were lower in the EUGR group.

CONCLUSIONS

Developmental outcome in preterm infants at a corrected age of 18months may be influenced by nutritional factors, including iron status, during their early life.

摘要

目的

我们的目的是评估有和没有宫外生长受限(EUGR)的婴儿的铁状态和神经发育结局。

方法

这项观察性研究评估了38名医学状况稳定、出生体重低于1500g的早产儿。通过测量静脉血中的血红蛋白(Hb)、铁(Fe)和血清铁蛋白水平来确定铁状态。将婴儿分为EUGR组和非EUGR组。在矫正年龄为18个月时,使用贝利量表检查神经发育结局,并测量体重、身长和头围。

结果

与非EUGR组相比,EUGR组在矫正年龄1个月和3个月时的Hb水平以及矫正年龄1个月和9个月时的铁水平显著较低。两组之间的智力发育指数(MDI)评分没有显著差异,但EUGR组在矫正年龄18个月时的运动发育指数(PDI)评分显著较低。我们发现1月龄时血清铁水平与18月龄时的PDI评分呈正相关。尽管EUGR组的体重和身长较低,但两组在矫正年龄18个月时的头围没有差异。

结论

矫正年龄为18个月的早产儿的发育结局可能受到其生命早期包括铁状态在内的营养因素的影响。

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