Neonatology and Neonatal Intensive Care, Children's Hospital of Brescia, Brescia, Italy.
Arch Dis Child Fetal Neonatal Ed. 2011 Sep;96(5):F355-8. doi: 10.1136/adc.2010.195099. Epub 2011 Jan 17.
Cerebral abnormalities detected by cranial ultrasound (cUS) have been reported in infants born to mothers with autoimmune disease. However, the pathogenesis of the infants' brain injury remains unclear. The authors aimed to study the possible association between abnormalities on neonatal cUS and perinatal factors related to maternal autoimmune disease.
cUS evaluation was carried out at birth in 114 infants born to mothers with autoimmune disease, and repeated up to 8-9 months of life in those showing sonographic abnormalities at the first examination. The authors analysed the relationships among cerebral ultrasound abnormalities and antenatal exposure to maternal drug treatment, placental transfer of auto-antibodies and gestational complications. In addition, infants were investigated for neuromotor development from birth to 24 months of age.
Cerebral ultrasound abnormalities, including subependymal pseudocyst, lenticulostriate vasculopathy and echogenic periventricular white matter, were detected in 41 of 114 infants (35.9%). No significant associations were found between abnormalities on cUS and the perinatal factors included in the study. No cases of persistent cerebral ultrasound abnormalities or neuromotor delay were observed during the follow-up period.
A considerable number of cerebral ultrasound abnormalities were observed in a cohort of infants born to mothers with autoimmune disease. However, no perinatal factors were significantly associated with this finding, suggesting the fetal brain impairment had a multi-factorial aetiology. Although no case of neuromotor delay was observed, long term neurological assessment of these babies is recommended in view of the cognitive impairment reported in previous studies.
已有研究报道，患有自身免疫性疾病的母亲所生婴儿会出现头颅超声（cranial ultrasound，cUS）检测到的脑异常。然而，婴儿脑损伤的发病机制尚不清楚。作者旨在研究新生儿 cUS 异常与与母体自身免疫性疾病相关的围产期因素之间的可能关联。
对 114 名患有自身免疫性疾病的母亲所生婴儿在出生时进行 cUS 评估，如果在首次检查时发现超声异常，则在 8-9 月龄时重复进行检查。作者分析了脑超声异常与产前母亲药物治疗、自身抗体胎盘转移和围产期并发症之间的关系。此外，从出生到 24 月龄对婴儿的神经运动发育进行了调查。
在 114 名婴儿中，有 41 名（35.9%）婴儿的 cUS 检测到脑超声异常，包括室管膜下假囊肿、纹状体血管病变和高回声脑室周围白质。cUS 异常与研究中纳入的围产期因素之间无显著相关性。在随访期间，未观察到持续的脑超声异常或神经运动发育迟缓病例。
在自身免疫性疾病母亲所生婴儿的队列中观察到相当数量的脑超声异常。然而，没有任何围产期因素与这一发现显著相关，这表明胎儿脑损伤的病因具有多因素性。尽管未观察到神经运动发育迟缓病例，但鉴于先前研究报道的认知障碍，建议对这些婴儿进行长期神经发育评估。
