Rotunda Hospital, Dublin, Ireland.
Am J Obstet Gynecol. 2013 Jul;209(1):29.e1-29.e19. doi: 10.1016/j.ajog.2013.03.023. Epub 2013 Mar 21.
The purpose of this study was to determine risk factors that are associated with hypoxic ischemic encephalopathy (HIE).
This was a case-control study that included newborn infants with HIE who were admitted to the hospital between January 2001 and December 2008. Two control newborn infants were chosen for each case. Logistic regression and classification and regression tree (CART) analysis that compared control infants and cases with grade 1 HIE and control infants and cases with grades 2 and 3 HIE was performed.
Two hundred thirty-seven cases (newborn infants with grade 1 encephalopathy, 155; newborn infants with grade 2 encephalopathy, 61; newborn infants with grade 3 encephalopathy, 21) and 489 control infants were included. Variables that were associated independently with HIE included higher grade meconium, growth restriction, large head circumference, oligohydramnios, male sex, fetal bradycardia, maternal pyrexia and increased uterine contractility. CART analysis ranked high-grade meconium, oligohydramnios, and the presence of obstetric complications as the most discriminating variables and defined distinct risk groups with HIE rates that ranged from 0-86%.
CART analysis provides information to help identify the time at which intervention in labor may be of benefit.
本研究旨在确定与缺氧缺血性脑病（HIE）相关的危险因素。
这是一项病例对照研究，纳入了 2001 年 1 月至 2008 年 12 月期间住院的患有 HIE 的新生儿。为每个病例选择了 2 个对照新生儿。对比较 1 级 HIE 组病例和对照婴儿以及 2-3 级 HIE 组病例和对照婴儿的控制婴儿进行了逻辑回归和分类回归树（CART）分析。
纳入了 237 例病例（1 级脑病新生儿 155 例，2 级脑病新生儿 61 例，3 级脑病新生儿 21 例）和 489 例对照婴儿。与 HIE 相关的独立变量包括胎粪分级较高、生长受限、头围较大、羊水过少、男性、胎儿心动过缓、母亲发热和子宫收缩力增加。CART 分析将高级胎粪、羊水过少和产科并发症的存在列为最具区分性的变量，并定义了具有 HIE 发生率为 0-86%的不同风险组。
CART 分析提供了有助于确定分娩时干预可能有益的时间的信息。
