母体（产前）子痫前期、HELLP 综合征和血栓形成倾向后出生婴儿的短期和长期结局：一项回顾性队列研究。

Princess Amalia Department of Paediatrics, Department of Neonatology, Isala Clinics, Zwolle, The Netherlands.

Eur J Obstet Gynecol Reprod Biol. 2010 Nov;153(1):47-51. doi: 10.1016/j.ejogrb.2010.07.004. Epub 2010 Jul 29.

OBJECTIVES

To investigate the short- and long-term outcome of children born from mothers with pre-eclampsia, eclampsia and/or HELLP syndrome, and to determine the differences between children born from mothers with and without underlying thrombophilic disorder.

STUDY DESIGN

Four hundred and nine infants (from 370 women) born between February 1991 and January 2006 were eligible for evaluation and were classified into group A (n = 162) and group B (n = 247). Thirty-four infants were not admitted to the hospital. Between-group differences were tested with regard to neonatal mortality, morbidity and follow-up measurements for neuromotor and mental development at 9 months and 2 years of age, using two-tailed Student's t-tests, Fisher's exact tests and logistic regression models.

RESULTS

Of the 409 infants, 44 infants (10.8%; n = 20 group A/n = 24 group B) died. The mean gestational age in both groups was 31.9 (SD: 3.5) weeks. Of the 375 admitted infants 152 (40.5%) were related to a thrombophilic mother and 223 (59.5%) were not. Six children were lost to follow-up. At 9 months and 2 years of age development was assessed in 326 surviving children. At 9 months of age, 193 (59.2%; n = 66 group A/n = 127 group B) children showed a normal (52% group A versus 63.8% group B, P=0.046), 24 (7.4%; n = 9 group A/n = 15 group B) a suspect and 14 (4.3%; n = 6 group A, n=8 group B) an abnormal development during follow-up assessment. Ninety-five children (29.1%; n = 46 group A/n = 49 group B) did not have a follow-up assessment. At 2 years of age, 112 children (34.4%; n = 43 group A/n = 69 group B) had a normal, 21 (6.4%; n = 11 group A/n = 10 group B) a suspect and 17 (5.2%; n = 5 group A/n = 12 group B) an abnormal development. 176 children (54%; n = 70 group A/n = 106 group B) did not have a follow-up assessment.

CONCLUSION

Short-term outcome was not different between infants from mothers with or without thrombophilic disorders. At 9 months of age, the probability of having a normal development was significantly lower in children born from a mother with an underlying thrombophilic disorder than in those without. At 2 years of age, no differences in development were observed.

目的

研究患有先兆子痫、子痫和/或 HELLP 综合征的母亲所生儿童的短期和长期结局，并确定患有和不患有潜在血栓形成障碍的母亲所生儿童之间的差异。

研究设计

1991 年 2 月至 2006 年 1 月期间，409 名婴儿（来自 370 名女性）符合评估条件，并分为 A 组（n = 162）和 B 组（n = 247）。34 名婴儿未住院。使用双尾学生 t 检验、Fisher 确切检验和逻辑回归模型，比较两组之间的新生儿死亡率、发病率以及 9 个月和 2 岁时的神经运动和精神发育随访测量值。

结果

409 名婴儿中，44 名（10.8%；n = 20 组 A/n = 24 组 B）死亡。两组的平均胎龄均为 31.9（SD：3.5）周。在 375 名入院婴儿中，152 名（40.5%）与血栓形成母亲有关，223 名（59.5%）没有。6 名儿童失访。在 9 个月和 2 岁时，对 326 名存活儿童进行了发育评估。9 个月时，193 名（59.2%；n = 66 组 A/n = 127 组 B）儿童表现出正常（52%组 A 与 63.8%组 B，P = 0.046），24 名（7.4%；n = 9 组 A/n = 15 组 B）可疑，14 名（4.3%；n = 6 组 A，n = 8 组 B）发育异常。95 名儿童（29.1%；n = 46 组 A/n = 49 组 B）未进行随访评估。2 岁时，112 名儿童（34.4%；n = 43 组 A/n = 69 组 B）发育正常，21 名（6.4%；n = 11 组 A/n = 10 组 B）可疑，17 名（5.2%；n = 5 组 A/n = 12 组 B）发育异常。176 名儿童（54%；n = 70 组 A/n = 106 组 B）未进行随访评估。