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早产婴儿出生后头两周的胎盘病理学与神经疾病

Placental pathology and neurological morbidity in preterm infants during the first two weeks after birth.

作者信息

Roescher A M, Timmer A, Hitzert M M, de Vries N K S, Verhagen E A, Erwich J J H M, Bos A F

机构信息

Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Early Hum Dev. 2014 Jan;90(1):21-5. doi: 10.1016/j.earlhumdev.2013.11.004. Epub 2013 Dec 10.

Abstract

BACKGROUND

The placenta plays a crucial role during pregnancy and dysfunction causes long-term neurological problems. Identifying placenta-related risks for neurological problems shortly after birth may provide clues for early interventions aiming to improve neurological outcome.

OBJECTIVE

To determine the association between placental pathology and neurological morbidity in preterm infants during the first two weeks after birth.

STUDY DESIGN

Placentas of 52 singleton, preterm infants (GA: 25-31weeks, BW: 560-2250 grammes) were examined for histopathology. The infants' neurological condition shortly after birth was determined by assessing the quality of their general movements (GMs): normal, abnormal, or hypokinetic, on days 5, 8, and 15. A motor optimality score (MOS) was also assigned.

RESULTS

Examination of the placentas revealed maternal vascular underperfusion (n=29), ascending intrauterine infection (AIUI) (n=19), villitis of unknown aetiology (n=6), chronic deciduitis (n=11), foetal thrombotic vasculopathy (FTV) (n=9), and elevated nucleated red blood cells (NRBCs) as a marker for foetal hypoxia (n=7). None of the placental lesions were significantly associated with the quality of GMs or MOS.

CONCLUSIONS

This study indicated that placental lesions were not associated with infants' neurological condition as measured by the quality of their general movements during the first two weeks after birth.

摘要

背景

胎盘在孕期发挥着关键作用,其功能障碍会导致长期的神经问题。识别出生后不久与胎盘相关的神经问题风险,可能为旨在改善神经结局的早期干预提供线索。

目的

确定出生后头两周内早产儿胎盘病理与神经疾病发生率之间的关联。

研究设计

对52例单胎早产儿(孕周:25 - 31周,体重:560 - 2250克)的胎盘进行组织病理学检查。通过在出生后第5天、第8天和第15天评估其全身运动(GMs)质量来确定婴儿出生后不久的神经状况:正常、异常或运动减少,并给出运动优化评分(MOS)。

结果

胎盘检查发现母体血管灌注不足(n = 29)、上行性宫内感染(AIUI)(n = 19)、病因不明的绒毛炎(n = 6)、慢性蜕膜炎(n = 11)、胎儿血栓性血管病(FTV)(n = 9)以及作为胎儿缺氧标志物的有核红细胞(NRBCs)升高(n = 7)。没有一种胎盘病变与GMs质量或MOS显著相关。

结论

本研究表明,胎盘病变与出生后头两周内通过全身运动质量衡量的婴儿神经状况无关。

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