Ferreira Rachel C, Mello Rosane R, Silva Kátia S
Instituto Fernandes Figueira, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
Instituto Fernandes Figueira, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
J Pediatr (Rio J). 2014 May-Jun;90(3):293-9. doi: 10.1016/j.jped.2013.09.006. Epub 2014 Feb 5.
to evaluate neonatal sepsis as a risk factor for abnormal neuromotor and cognitive development in very low birth weight preterm infants at 12 months of corrected age.
this was a prospective cohort study that followed the neuromotor and cognitive development of 194 very low birth weight preterm infants discharged from a public neonatal intensive care unit. The Bayley Scale of Infant Development (second edition) at 12 months of corrected age was used. The outcomes were the results of the clinical/neurological evaluation and the scores of the psychomotor development index (PDI) and mental development index (MDI) of the Bayley Scale of Infant Development II. The association between neonatal sepsis and neuromotor development and between neonatal sepsis and cognitive development was verified by logistic regression analysis.
mean birth weight was 1,119g (SD: 247) and mean gestational age was 29 weeks and 6 days (SD: 2). Approximately 44.3%(n=86) of the infants had neonatal sepsis and 40.7% (n=79) had abnormal neuromotor development and/or abnormal psychomotor development index (PDI < 85) at 12 months of corrected age. On the mental scale, 76 (39.1%) children presented abnormal cognitive development (MDI<85). Children with neonatal sepsis were 2.5 times more likely to develop changes in neuromotor development (OR: 2.50; CI: 1.23-5.10). There was no association between neonatal sepsis and cognitive development impairment.
neonatal sepsis was an independent risk factor for neuromotor development impairment at 12 months of corrected age, but not for mental development impairment.
评估新生儿败血症作为矫正年龄12个月时极低出生体重早产儿神经运动和认知发育异常的风险因素。
这是一项前瞻性队列研究，对194名从公共新生儿重症监护病房出院的极低出生体重早产儿的神经运动和认知发育进行随访。使用矫正年龄12个月时的贝利婴儿发育量表（第二版）。结果为临床/神经学评估结果以及贝利婴儿发育量表II的心理运动发育指数（PDI）和智力发育指数（MDI）得分。通过逻辑回归分析验证新生儿败血症与神经运动发育之间以及新生儿败血症与认知发育之间的关联。
平均出生体重为1119克（标准差：247），平均胎龄为29周零6天（标准差：2）。约44.3%（n = 86）的婴儿患有新生儿败血症，40.7%（n = 79）在矫正年龄12个月时存在神经运动发育异常和/或心理运动发育指数异常（PDI < 85）。在智力量表上，76名（39.1%）儿童存在认知发育异常（MDI < 85）。患有新生儿败血症的儿童神经运动发育出现变化的可能性高2.5倍（比值比：2.50；可信区间：1.23 - 5.10）。新生儿败血症与认知发育障碍之间无关联。
新生儿败血症是矫正年龄12个月时神经运动发育障碍的独立风险因素，但不是智力发育障碍的独立风险因素。
