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宫内生长受限(IUGR)的短期和长期后遗症

Short-term and long-term sequelae in intrauterine growth retardation (IUGR).

作者信息

Longo Stefania, Bollani Lina, Decembrino Lidia, Di Comite Amelia, Angelini Mauro, Stronati M

机构信息

Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

出版信息

J Matern Fetal Neonatal Med. 2013 Feb;26(3):222-5. doi: 10.3109/14767058.2012.715006. Epub 2012 Oct 3.

Abstract

Intrauterine Growth Retardation (IUGR) is defined as a rate of growth of a fetus that is less than normal for the growth potential of the fetus (for that particular gestational age). Small for Gestational Age (SGA) is defined infant born following IUGR, with a weight at birth below the 10th percentile.Suboptimal fetal growth occurring in IUGR fetuses is an important cause of perinatal mortality and morbidity. The acute neonatal consequences of IUGR include metabolic and hematological disturbances, and disrupted thermoregulation; in addition, respiratory distress (RDS), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP) may contribute to perinatal morbidity. Metabolic disturbances are related to glucose and fatty acid metabolism. It is well-known that individuals who display poor growth in utero are at significantly increased risk for type 2 diabetes mellitus (T2DM), obesity, hypertension, dyslipidemia, and insulin resistance (the so-called metabolic syndrome, MS). MS ultimately leads to the premature development of cardiovascular diseases. In addition, short stature in children and adults, premature adrenarche, and the polycystic ovarian syndrome (PCOS) are endocrinological sequelae of IUGR. (8) Early onset growth delay and prematurity significantly increase the risk for neurological sequelae and motor and cognitive delay.Future prospective studies need to investigate risk factors for infants who are SGA. If reliable prediction can be achieved, there is potential to reduce future perinatal morbidity and mortality, and long term consequences among SGA babies.

摘要

宫内生长受限(IUGR)的定义是胎儿的生长速率低于其生长潜力(针对该特定孕周)的正常水平。小于胎龄儿(SGA)定义为因IUGR出生的婴儿,出生体重低于第10百分位数。IUGR胎儿出现的胎儿生长欠佳是围产期死亡率和发病率的重要原因。IUGR的急性新生儿后果包括代谢和血液学紊乱以及体温调节障碍;此外,呼吸窘迫(RDS)、坏死性小肠结肠炎(NEC)和早产儿视网膜病变(ROP)可能导致围产期发病。代谢紊乱与葡萄糖和脂肪酸代谢有关。众所周知,子宫内生长不良的个体患2型糖尿病(T2DM)、肥胖、高血压、血脂异常和胰岛素抵抗(即所谓的代谢综合征,MS)的风险显著增加。MS最终会导致心血管疾病过早发展。此外,儿童和成人身材矮小、性早熟和多囊卵巢综合征(PCOS)是IUGR的内分泌后遗症。(8)早发性生长发育迟缓与早产会显著增加神经后遗症以及运动和认知发育迟缓的风险。未来的前瞻性研究需要调查SGA婴儿的风险因素。如果能够实现可靠的预测,就有可能降低未来SGA婴儿的围产期发病率和死亡率以及长期后果。

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