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胎儿生长受限对儿童认知发育的影响

Childhood cognitive development after fetal growth restriction.

机构信息

Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.

出版信息

Ultrasound Obstet Gynecol. 2013 Apr;41(4):383-9. doi: 10.1002/uog.12388.

Abstract

OBJECTIVE

To examine the relationship between prenatal umbilical artery (UA) and internal carotid artery (ICA) Doppler findings and cognitive development at 3 and 6 years in low-birth-weight children.

METHODS

This was a study of 209 low-birth-weight (< 10(th) centile) children born after 28 gestational weeks with UA resistance index (RI) measured within 2 weeks before delivery. Children with normal UA- and ICA-RI were defined as small-for-gestational age (SGA) and those with abnormal UA or ICA Doppler findings as having fetal growth restriction (FGR). Cognitive ability at 3 and 6 years' corrected age was assessed using the fourth edition of the Stanford-Binet Intelligence Scale (SBIS) and compared between SGA and FGR groups. An SBIS score < 85 was considered to indicate delayed development.

RESULTS

The median gestational age at diagnosis of abnormal fetal growth was 36.6 (range, 28-41) weeks. There were 87 (41.6%) children classified as having FGR and 122 (58.4%) as SGA. The mean global SBIS score at 3 years was 109.4 (SD, 22.8) and at 6 years it was 110.5 (SD, 13.9). Overall, 22 (10.5%) children had delayed development at 3 years. Total SBIS scores and individual domain scores did not differ between FGR and SGA groups at 3 or 6 years and similar proportions in each group had delayed development.

CONCLUSION

Abnormal prenatal UA and ICA Doppler findings are not associated with lower developmental scores in low-birth-weight children delivered in the third trimester of pregnancy.

摘要

目的

研究低出生体重儿(出生体重<第 10 百分位数)产前脐动脉(UA)和颈内动脉(ICA)多普勒检查结果与 3 岁和 6 岁时认知发育的关系。

方法

这是一项研究 209 例出生胎龄 28 周后低出生体重儿的研究,在分娩前 2 周内测量 UA 阻力指数(RI)。UA-RI 正常的儿童定义为小于胎龄儿(SGA),UA 或 ICA 多普勒异常的儿童定义为胎儿生长受限(FGR)。使用斯坦福-比奈智能量表第四版(SBIS)评估校正年龄 3 岁和 6 岁时的认知能力,并比较 SGA 和 FGR 组之间的差异。SBIS 评分<85 被认为是发育迟缓。

结果

异常胎儿生长的中位诊断胎龄为 36.6(范围 28-41)周。87 例(41.6%)儿童被诊断为 FGR,122 例(58.4%)为 SGA。3 岁时平均 SBIS 总分为 109.4(标准差 22.8),6 岁时为 110.5(标准差 13.9)。总的来说,22 例(10.5%)儿童在 3 岁时发育迟缓。3 岁和 6 岁时,FGR 和 SGA 组之间的总 SBIS 评分和各领域评分没有差异,每组中发育迟缓的比例相似。

结论

在妊娠晚期分娩的低出生体重儿中,产前 UA 和 ICA 多普勒异常与较低的发育评分无关。

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