Department of Neonatolog, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
Neonatology. 2012;101(3):210-6. doi: 10.1159/000331797. Epub 2011 Nov 10.
Preterm infants with progressive post-hemorrhagic ventricular dilatation (PHVD) in the absence of associated parenchymal lesions may have a normal neurodevelopmental outcome.
To evaluate neurodevelopmental and cognitive outcomes among preterm infants with severe intraventricular hemorrhage (IVH) and PHVD requiring neurosurgical intervention.
32 preterm infants were admitted to a neonatal intensive care unit with PHVD requiring neurosurgical intervention, and were seen in the follow-up clinic for standardized cognitive, behavioral and neurological assessments between 5 and 8 years of age. Only preterm infants with a gestational age (GA) of <30 weeks, as well as preterm and full-term infants with PHVD and full-term infants with perinatal asphyxia are seen in our follow-up clinic at this age. There were 23 infants with a GA of <30 weeks in this study population. For these 23, matched controls were available and compared with the IVH group.
The majority (59.4%) had no impairments. None of the children with grade III and 8 of the 15 children (53%) with grade IV hemorrhage developed cerebral palsy. More subtle motor problems assessed with the Movement-ABC score were seen in 39% (n = 9); the mean IQ of all children was 93.4, and 29% of the children had an IQ of <85 (-1 SD). Timing of intervention did not have a beneficial effect on outcome. With respect to cognition, no significant differences were found between the IVH and the control group.
The majority of the children in our population had no impairments. Cerebral palsy was not seen in any of the infants with a grade III hemorrhage.
在没有相关实质病变的情况下，患有进行性出血后脑室扩张（PHVD）的早产儿可能具有正常的神经发育结局。
评估需要神经外科干预的严重脑室出血（IVH）和 PHVD 的早产儿的神经发育和认知结局。
32 名早产儿因 PHVD 需要神经外科干预而入住新生儿重症监护病房，并在 5 至 8 岁时在随访诊所接受标准化认知、行为和神经评估。只有胎龄（GA）<30 周的早产儿、伴有 PHVD 的早产儿和足月儿以及围产期窒息的足月儿在我们的随访诊所接受此年龄的评估。在本研究人群中，有 23 名 GA<30 周的早产儿。对于这 23 名早产儿，有匹配的对照组，并与 IVH 组进行比较。
大多数（59.4%）没有损伤。无 III 级出血的患儿无一例发生脑瘫，15 例 IV 级出血患儿中有 8 例（53%）发生脑瘫。运动 ABC 评分评估的更微妙的运动问题见于 39%（n=9）；所有儿童的平均智商为 93.4，29%的儿童智商<85（-1SD）。干预的时机对结局没有有益的影响。关于认知，IVH 组和对照组之间没有发现显著差异。
在我们的人群中，大多数儿童没有损伤。任何 III 级出血的婴儿都没有脑瘫。
