足月出生且脐动脉多普勒正常但小于胎龄的婴儿出现轴突丢失和认知缺陷。

Axonal loss and cognitive deficits in term infants with normal umbilical artery Doppler born small-for-gestational age.

机构信息

Ophthalmology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain.

出版信息

Ultrasound Obstet Gynecol. 2012 Sep;40(3):297-303. doi: 10.1002/uog.11215.

DOI:10.1002/uog.11215

PMID:22740299

Abstract

OBJECTIVE

To assess cognitive outcomes and structural changes in the central nervous system, the latter using a novel approach to examine changes in neuronal integrity of the optic nerve, in children at 5-6½ years of age who were born small-for-gestational age (SGA) at term having shown normal umbilical artery (UA) Doppler.

METHODS

We compared neuronal damage, cognitive deficits and visuospatial perception in two cohorts of infants, one born SGA (n = 40) and one born appropriate-for-gestational age (AGA) (n = 39) in weight. Neuronal damage was evaluated using optical coherence tomography (OCT) of the optic nerve. Cognitive deficits were assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) test. Visuospatial perception was evaluated with Rey-Osterreich Complex Figure (ROCF) tasks.

RESULTS

Children from the SGA group had a significantly thinner average retinal nerve fiber layer (RNFL) compared with those from the AGA group (98.2 vs 104.5 µm, P = 0.012). Children from the SGA group exhibited impaired performance in copy tasks on the ROCF (3.27 vs 3.56, P = 0.036) and a higher rate of suboptimal WPPSI test performance intelligence quotient scores (15% vs 0%; P = 0.025) compared with those from the AGA group.

CONCLUSION

Term infants with normal UA Doppler born SGA are at increased risk for cognitive deficits and axonal loss in the RNFL at the age of 5-6½ years.

摘要

目的

评估认知结果和中枢神经系统结构变化，后者采用一种新方法检查视神经神经元完整性的变化，研究对象为足月出生时体重小于胎龄（SGA）但脐动脉（UA）多普勒正常的 5-6 岁半儿童。

方法

我们比较了两个队列的婴儿的神经元损伤、认知缺陷和视空间感知，一个队列由 SGA（n = 40）出生的婴儿组成，另一个队列由 AGA（n = 39）出生的婴儿组成，两者出生体重相当。视神经的光学相干断层扫描（OCT）用于评估神经元损伤。韦氏学前和初级智力量表（WPPSI）测试评估认知缺陷。 Rey-Osterreich 复杂图形（ROCF）任务评估视空间感知。

结果

与 AGA 组相比，SGA 组的平均视网膜神经纤维层（RNFL）明显更薄（98.2 µm 对 104.5 µm，P = 0.012）。与 AGA 组相比，SGA 组的儿童在 ROCF 的复制任务中表现出受损（3.27 对 3.56，P = 0.036），并且 WPPSI 测试表现不佳的智商分数（15% 对 0%；P = 0.025）的比例更高。