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极早产儿24个月时的脑室内出血与发育结局

Intraventricular hemorrhage and developmental outcomes at 24 months of age in extremely preterm infants.

作者信息

O'Shea T Michael, Allred Elizabeth N, Kuban Karl C K, Hirtz Deborah, Specter Barbara, Durfee Sara, Paneth Nigel, Leviton Alan

机构信息

Wake Forest School of Medicine, Winston-Salem, NC, USA.

出版信息

J Child Neurol. 2012 Jan;27(1):22-9. doi: 10.1177/0883073811424462.

Abstract

Whether intraventricular hemorrhage increases the risk of adverse developmental outcome among premature infants is controversial. Using brain ultrasound, we identified intraventricular hemorrhage and white matter abnormalities among 1064 infants born before 28 weeks' gestation. We identified adverse developmental outcomes at 24 months of age using a standardized neurologic examination and the Bayley Scales of Infant Development Mental and Motor Scales. In logistic regression models that adjusted for gestational age, sex, and public insurance, isolated intraventricular hemorrhage was associated with visual fixation difficulty but no other adverse outcome. Infants who had a white matter lesion unaccompanied by intraventricular hemorrhage were at increased risk of cerebral palsy, low Mental and Motor Scores, and visual and hearing impairments. Except when accompanied or followed by a white matter lesion, intraventricular hemorrhage is associated with no more than a modest increase (and possibly no increase) in the risk of adverse developmental outcome during infancy.

摘要

脑室内出血是否会增加早产儿出现不良发育结局的风险,这一问题存在争议。我们通过脑部超声检查,在1064名孕周小于28周出生的婴儿中确定了脑室内出血和白质异常情况。我们使用标准化神经学检查以及贝利婴儿发育量表的心理和运动量表,确定了这些婴儿在24个月大时的不良发育结局。在调整了孕周、性别和公共保险因素的逻辑回归模型中,单纯的脑室内出血与视觉注视困难有关,但与其他不良结局无关(译者注:原文no other adverse outcome表述有误)。有白质病变但无脑室内出血的婴儿患脑瘫、心理和运动评分低以及视觉和听力障碍风险增加。除非伴有白质病变或随后出现白质病变,否则脑室内出血仅会使婴儿期出现不良发育结局的风险适度增加(也可能没有增加)。

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