Klebermass-Schrehof K, Czaba C, Olischar M, Fuiko R, Waldhoer T, Rona Z, Pollak A, Weninger M
Division of Neonatology; Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Childs Nerv Syst. 2012 Dec;28(12):2085-92. doi: 10.1007/s00381-012-1897-3. Epub 2012 Aug 23.
Despite a decreasing incidence, intraventricular hemorrhage (IVH) remains a point of major concern in neonatology due to its association to adverse neurodevelopmental outcome (NDO). Aim of this study was to compare outcome of preterm infants with different grades of IVH born below 32 weeks of gestational age (GA) with outcome of controls without IVH and to especially evaluate the influence of low grade IVH on NDO.
Four hundred seventy-one preterm infants with a GA below 32 weeks were admitted to our neonatal intensive care unit between 1994 and 2005 and included into analysis.
IVH patients showed significantly lower mean psychomotor and mental developmental indices and a significantly higher percentage of cerebral palsy and visual impairment. Results of IVH patients born below 28 weeks of GA were significantly worse than results of IVH patients born at or above 28 weeks of GA. In all parameters, an increase of abnormal results with increasing grade of IVH could be observed; even patients with low-grade IVH (grades I and II) showed higher percentages of impairment compared to controls without any IVH.
Even low-grade IVH has an significant impact on neurodevelopmental outcome of preterm patients and gestational age influences the impact of intraventricular hemorrhage on neurodevelopmental outcome.
尽管脑室内出血(IVH)的发病率在下降,但由于其与不良神经发育结局(NDO)相关,仍是新生儿学中主要关注的问题。本研究的目的是比较孕周小于32周的不同等级IVH早产儿与无IVH对照组的结局,并特别评估轻度IVH对NDO的影响。
1994年至2005年间,471例孕周小于32周的早产儿入住我们的新生儿重症监护病房并纳入分析。
IVH患者的平均精神运动和智力发育指数显著较低,脑瘫和视力障碍的百分比显著较高。孕周小于28周的IVH患者的结果明显比孕周在28周及以上的IVH患者差。在所有参数中,可观察到随着IVH等级的增加,异常结果增多;即使是轻度IVH(I级和II级)患者与无任何IVH的对照组相比,受损百分比也更高。
即使是轻度IVH也对早产儿的神经发育结局有显著影响,孕周会影响脑室内出血对神经发育结局的影响。