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先天性腹壁缺损患儿 1 岁时的生长和发育结局:一项回顾性研究。

Growth and developmental outcomes of infants with gastroschisis at one year of age: a retrospective study.

机构信息

Department of Neonatology, Princess Margaret Hospital for Children, Perth, Western Australia.

出版信息

J Pediatr Surg. 2013 Aug;48(8):1688-96. doi: 10.1016/j.jpedsurg.2012.11.046.

Abstract

BACKGROUND

The aim of the study was to describe the physical growth and developmental outcomes of babies born with gastroschisis.

METHODS

We retrospectively reviewed all cases of gastroschisis in Western Australia born between 1997 and 2010.

RESULTS

In the 128 pregnancies with fetal gastroschisis, 117 babies were live born. 112 (95.7%) survived to one year. 19% had z scores of<-1.28 for weight at birth (<10th centiles) compared with 30% at one year. Neurodevelopmental data were available in 88/112 (79%) of survivors (Griffiths scores in 67; reports of ages and stages questionnaire (ASQ) in 21). The mean GQ at 12 months was 99 (SD 9.8). Suboptimal neurodevelopmental outcomes were noted in eight. Complex gastroschisis (present at birth) and acquired gut related complications were associated with adverse long term outcomes. The incidence of acquired gut complications was least (5%) in those who underwent silo reduction as the primary management. However, on univariate and multivariate analysis, the type of primary reduction did not significantly influence the outcome.

CONCLUSIONS

A large proportion of infants with gastroschisis exhibit suboptimal weight gain during the first year. The incidence of adverse developmental outcomes appears to be low.

摘要

背景

本研究旨在描述先天性腹裂患儿的体格生长和发育结局。

方法

我们回顾性分析了 1997 年至 2010 年期间在西澳大利亚出生的所有先天性腹裂病例。

结果

在 128 例胎儿腹裂妊娠中,有 117 例婴儿为活产。112 例(95.7%)存活至 1 岁。与 1 岁时相比,出生时体重 z 值<-1.28(<10 百分位数)的患儿占 19%,而 1 岁时为 30%。在 112 例存活者中(88%)有神经发育数据(Griffiths 评分 67 分,年龄和阶段问卷(ASQ)报告 21 分)。12 个月时的平均 GQ 为 99(SD 9.8)。8 例患儿存在神经发育不良。复杂的腹裂(出生时存在)和获得性肠道相关并发症与不良的长期结局相关。在接受造口袋减压作为主要治疗的患儿中,获得性肠道并发症的发生率最低(5%)。然而,单因素和多因素分析均显示,主要减压方式并未显著影响结局。

结论

很大一部分先天性腹裂患儿在出生后第一年体重增长不理想。不良发育结局的发生率似乎较低。

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